- 期刊
Acute Pancreatitis Complicated with Transient Portal Venous Thrombosis in One Patient with Hepatocellular Carcinoma and Cirrhosis
合併肝癌肝硬化病人因急性胰臟炎產生暫時性門靜脈栓塞－個案報告
摘要
門靜脈栓塞易導致高死亡率。造成門靜脈栓塞的原因包含了腹腔內發炎、感染、開刀、腹腔內惡性腫瘤（如肝癌、胰臟癌），與凝血機能障礙（先天性疾病、肝硬化），對治療門靜脈栓塞之方法並非一成不變且各有其可能出現之副作用，因此正確之治療須取決於其造成之原因與病人之情況。我們報告一位33歲男性併有肝癌、肝硬化因急性胰臟炎而產生暫時性門靜脈栓塞之個案。造成此門靜脈栓塞之原因推斷是因胰臟炎造成門靜脈血管發炎所致。對於門靜脈栓塞，我們採取密切追蹤之因應方式。在急性胰臟炎改善後，影像追蹤顯示門靜脈栓塞完全消失。我們的經驗可提供臨床醫師往後治療疑似此類病人之參考。
並列摘要
Portal venous thrombosis (PVT) is a condition associated with high morbidity. The etiologies of PVT include intra-abdominal inflammation or infection, surgical intervention, abdominal malignancies such as hepatocellular carcinoma (HCC) and pancreatic carcinoma, or abnormality in coagulation caused by various reasons such as liver cirrhosis. Management of PVT should be based on its etiology and the condition of the patient. We describe a cirrhotic patient with HCC who suffered from acute pancreatitis. PVT in the main trunk was detected at admission due to the episode of acute pancreatitis. The etiology of thrombosis was considered to be inflammation around the main portal trunk caused by pancreatitis rather than cirrhosis or HCC. We did not instigate any management for the thrombosis. Acute pancreatitis was relieved after conservative treatment. Follow-up imaging study performed 46 days after detection of thrombosis showed spontaneous complete resolution of the thrombus. Our experience may provide useful information for the management of such patients.