ID | 47084 |
フルテキストURL | |
タイトル(別表記) | Splenic artery syndrome after living donor liver transplantation with ligation of the splenic artery : A case report
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著者 |
佐藤 太祐
岡山大学大学院医歯薬学総合研究科 消化器外科学
楳田 祐三
岡山大学大学院医歯薬学総合研究科 消化器外科学
吉田 龍一
岡山大学大学院医歯薬学総合研究科 消化器外科学
内海 方嗣
岡山大学大学院医歯薬学総合研究科 消化器外科学
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抄録 | After orthotopic liver transplantation, splenic artery syndrome (SAS), a phenomenon by which the main blood flow of the impaired hepatic artery is shifted to the splenic artery or gastroduodenal artery despite the absence of a structural lesion involving the anastomosis, has occasionally been observed. We report a 20-year-old women who developed SAS with pancytopenia and refractory ascites after living donor liver transplantation despite intraoperative ligation of the splenic artery as a prophylactic treatment for SAS. In this case SAS was diagnosed by digital subtraction angiography (DSA). A celiac trunk angiogram showed relative hypoperfusion of the hepatic artery together with augmentation of the blood flow toward the spleen with the unique collateral circulation through the left gastric artery, stomach and short gastric artery, and distal splenic artery. Embolization of one of the two left gastric arteries was performed. After embolization the hepatic artery perfusion showed significant improvement, but reduced again the next day. We ultimately conducted splenectomy. This case showed portal hyperperfusion and portal hypertension, consistent with previous reports that have described an association of SAS with portal hyperperfusion. After splenectomy, there was significant improvement in the hepatic artery perfusion, ascites disappeared promptly, and pancytopenia was significantly improved.
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キーワード | 脾動脈症候群 (splenic artery syndrome)
脾動脈結紮 (ligation of the splenic artery)
生体肝移植 (living donor liver transplantation)
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備考 | 症例報告 (Case Report)
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発行日 | 2011-12-01
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出版物タイトル |
岡山医学会雑誌
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出版物タイトル(別表記) | Journal of Okayama Medical Association
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巻 | 123巻
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号 | 3号
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出版者 | 岡山医学会
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出版者(別表記) | Okayama Medical Association
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開始ページ | 207
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終了ページ | 211
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ISSN | 0030-1558
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NCID | AN00032489
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資料タイプ |
学術雑誌論文
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関連URL | http://www.okayama-u.ac.jp/user/oma/
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言語 |
日本語
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著作権者 | Copyright (c) 2011 岡山医学会
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論文のバージョン | publisher
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査読 |
有り
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DOI | |
Eprints Journal Name | joma
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