Transcatheter Therapy of Budd-Chiari Syndrome in a Child after Liver Transplantation: Report of One Case

經導管治療兒童換肝後Budd-Chiari症候群：一病例報告

何季麟(Chi-Lin Ho) ； 傅雲慶(Yun-Ching Fu) ； 林捷忠(Chieh-Chung Lin) ； 鄭紹彬(Shao-Bin Cheng) ； 詹聖霖(Sheng-Ling Jan) ； 林明志(Ming-Chih Lin) ； 遲景上(Ching-Shiang Chi) ； 黃碧桃(Betau Hwang)

《Acta Paediatrica Taiwanica》 48卷5期 (2007/10) Pp. 276-279

https://doi.org/10.7097/APT.200710.0276

摘要

Budd-Chiari症候群爲一罕見，由各種不同疾病引起的肝靜脈回流阻寨所造成的可能致命性疾病。典型的臨床表現包括肝腫大，腹水及腹痛。大多數病例起因於不止常的凝血病變，感染，發炎或腫瘤侵犯。換肝後Budd-Chiari症候群在兒科病人是很少被提到的。在此我們報告一位患有膽道閉鎖的四歲女孩在接受活體肝臟移植後兩個月發生嚴重腹水，診斷爲Budd-Chiari症候群。心導管顯示病人的人腔靜脈及肝靜脈有顯著狹窄，開始時先氣球擴張其下腔靜脈，狹窄僅得輕微改善。等成功擴張肝靜脈狹窄後，其下腔靜脈狹窄立刻同時獲得改善。術後腹水很快地消退，追蹤八個月末再有腹水發生。

關鍵字

氣球血管成形術 ； Budd-Chiari症候群 ； 肝臟移植 ； 兒童

並列摘要

Budd-Chiari syndrome is a rare, heterogenous and potentially lethal condition due to hepatic venous outflow obstruction. Classic triads include hepatomegaly, ascites and abdominal pain. Most cases are caused by abnormal coagulopathy, infection, inflammation or tumor invasion. Status post liver transplantation was rarely mentioned in the pediatric group. Here we report a case of 4-year-old girl with biliary atresia status post living donor liver transplantation. Marked ascites developed 2 months later and Budd-Chiari syndrome was diagnosed. Cardiac catheterization showed significant stenoses of the hepatic vein and inferior vena cava. Initial balloon angioplasty of inferior vena cava only resulted in mild improvement. After successful balloon angioplasty of the hepatic vein stenosis, the stenosis of the inferior vena cava improved significantly. The ascites resolved soon, and no more happened up to 8 months’ follow-up.

並列關鍵字

balloon angioplasty ； Budd-Chiari syndrome ； liver transplantation ； child