- 期刊
Long-term Follow-up of Partial Thrombosis of the Superior Mesenteric Vein in a Cirrhotic Patient with Hepatocellular Carcinoma: A Case Report
長期追蹤一位肝硬化合併肝癌患者之上腸系膜靜脈不完全栓塞－病例報告
摘要
上腸系膜靜脈栓塞（SMVT）是一少見但有可能導致喪命的疾患。本文提出一位肝硬化合併肝癌之患者，其SMVT為不完全阻塞且持續至少２８個月。在發現SMVT時，因患者有嚴重出血傾向又無腸梗塞之跡象，且其狀況也甚差，因此我們並未積極治療SMVT，而採取定期以超音波追蹤觀察。此不完全阻塞之SMVT於追蹤期間其形態並無明顯改變，追蹤期間出現可能與SMVT有關之症狀為飯後常有腹部絞痛現象，有時合併腹瀉及／或反胃及嘔吐，患者均無出現腸梗塞之跡象，腹痛則以anti-cholinergic藥物有時合併止痛藥而改善。
並列摘要
Superior mesenteric venous thrombosis (SMVT) is an uncommon but potentially life-threatening disorder. We describe a cirrhotic patient with hepatocellular carcinoma who had partial SMVT for at least 28 months. Our experience may help in the management of such patients. The partial SMVT was not treated at the time of discovery because there was no evidence of bowel infarction. Moreover, the patient had a tendency to bleed severely and was in a poor condition. SMVT was followed using regular ultrasonography and the pattern of SMVT did not change significantly during the follow-up period. A symptom that may have been related to SMVT was abdominal colic pain after meals, which was sometimes followed by diarrhea and /or nausea and vomiting. There was no evidence of bowel ischemia or infarction during follow-up. Abdominal discomfort can be successfully treated using anticholinergic drugs with or without analgesia.
延伸閱讀
- Lin, I. C., Fang, C. Y., Huang, Y. C., Dai, Y. C., & Hsieh, M. C. (2014). 大腸直腸癌合併門靜脈腫瘤栓塞及肝轉移. 中華民國大腸直腸外科醫學會雜誌, 25(1), 21-25. https://doi.org/10.6312/SCRSTW.2014.25(1).10304
- 林翠華（2011）。肝癌行經導管肝動脈化學栓塞病患之症狀困擾及症狀群集〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2308201201051500
- Chou, Y. P., Lee, P. L., Cheng, Y. F., Lu, S. N., Changchien, C. S., & Wang, J. H. (2003). 肝癌肝門靜脈栓塞自然消失後引發肝門靜脈高壓及併發症：一病例報告. 臺灣消化醫學雜誌, 20(4), 245-251. https://doi.org/10.6557/GJT.200312_20(4).0002
- 郭萬祐、楊建芳、蘇友吉、田雨生、何永仁、姜仁惠、張遵（1985）。肝癌之肝動脈門脈間瘻管栓塞治療－病例報告。中華放射線醫學雜誌，10(2)，143-146。https://www.airitilibrary.com/Article/Detail?DocID=10188940-198506-10-2-143-146-a
- Hong, T. M., Lee, R. C., Chiang, J. H., & Chang, C. Y. (2001). 中心位置硬化性肝細胞癌於動脈栓塞治療前後之影像學發現：一病例報告. 中華放射線醫學雜誌, 26(3), 147-152. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200106-26-3-147-152-a