Diagnosis and Treatment of Lower Gastrointestinal Bleeding Caused by Abernethy Malformation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 李震 ¹ , 汪忠镐 ^1,2 , 赵克 ³ , 卞策 ³ , 韩冰 ³ , 郭巍 ³ , 崔琦 ³ , 霍小森 ¹ , 王雷永 ¹

Corresponding author：

李震, Email: zhenli0328@hotmail.com

Keywords：

Abernethy畸形; 下消化道; 出血; 手术; 中药

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的探讨Abernethy畸形致下消化道出血的诊断及治疗方法。
方法回顾1例Abernethy畸形患者的诊治情况，并结合相关文献进行分析。
结果血管造影确诊后经积极术前准备，行剖腹探查、乙状结肠造瘘术，术后3周开始给予中药保留灌肠至术后7周，6个月关闭造瘘,3周后继续辅以中药保留灌肠4周。患者顺利恢复出院，随访9个月未再次出血。
结论正确的诊断及合理的治疗方案是救治的关键。

Citation： 李震,汪忠镐,赵克,卞策,韩冰,郭巍,崔琦,霍小森,王雷永. Diagnosis and Treatment of Lower Gastrointestinal Bleeding Caused by Abernethy Malformation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(1): 83-84. doi: Copy

1.	Abernethy J. Account of two instances of uncommon formation in the viscera of the human body [Ｊ]. Phil Trans R Soc, 1793; 83: 5966.
2.	陈国庭, 李恒平. Abernethy畸形一例 [Ｊ]. 中华普通外科杂志, 2005; 20(5): 328.
3.	陈诚豪, 王大勇, 李小松, 等. 先天性肝外门腔静脉分流并下消化道出血1例 [Ｊ]. 临床小儿外科杂志, 2007; 6(2): 7879.
4.	Murray CP, Yoo SJ, Babyn PS. Congenital extrahepatic portosystemic shunts [Ｊ]. Pediatr Radiol, 2003; 33(9): 614620.
5.	Kumar A, Kumar J, Aggarwal R, et al. Abernethy malformation with portal vein aneurysm [Ｊ]. Diagn Interv Radiol, 2008; 14(3): 143146.
6.	Oei M, Wessling J. Abernethy malformation-congenital aplasia of the portal vein a 29yearold patient [Ｊ]. Rofo, 2007; 179(2): 167169.
7.	Abernethy LJ. Classification and imaging of vascular malformations in children [Ｊ]. Eur Radiol, 2003; 13(11): 24832497.
8.	Howard ER, Davenport M. Congenital extrahepatic portocaval shuntsthe Abernethy malformation (Review) [Ｊ]. J Pediatr Surg, 1997; 32(3): 494497.
9.	Moon SB, Park KW, Jung SE. Abnormal direct entry of the umbilical vein into the portal vein: report of a case [Ｊ]. Pediatr Surg Int, 2008; 24(11): 12431245.
10.	Ringe K, Schirg E, Melter M, et al. Congenital absence of the portal vein (CAPV). Two cases of Abernethy malformation type 1 and review of the literature [Ｊ]. Radiologe, 2008; 48(5): 493502.
11.	Witters P, Maleux G, George C, et al. Congenital venovenous malformations of the liver: widely variable clinical presentations [Ｊ]. J Gastroenterol Hepatol, 2008; 23(8 Pt 2): e390e394.
12.	Stringer MD. The clinical anatomy of congenital portosystemic venous shunts [Ｊ]. Clin Anat, 2008; 21(2): 147157.
13.	Morikawa N, Honna T, Kuroda T, et al. Resolution of hepatopulmonary syndrome after ligation of a portosystemic shunt in a pediatric patient with an Abernethy malformation [Ｊ]. J Pediatr Surg, 2008; 43(2): e35e38.
14.	Emre S, Arnon R, Cohen E, et al. Resolution of hepatopulmonary syndrome after auxiliary partial orthotopic liver transplantation in Abernethy malformation. A case report [Ｊ]. Liver Transpl, 2007; 13(12): 16621668.
15.	吴继东, 汪忠镐, 王仕华, 等. 儿童肝外型门脉高压症的诊治 [Ｊ]. 中国现代手术学杂志, 2003; 7(5): 375377.
16.	王欣博, 童中勋, 刘威, 等. 门静脉海绵样变性外科治疗的研究进展 [Ｊ]. 中国普外基础与临床杂志， 2008; 15(12): 877879.
17.	盖保东, 王正峰, 刘东. 门脉高压性胃病 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(12): 880882.
18.	Tercier S, Delarue A, Rouault F, et al. Congenital portocaval fistula associated with hepatopulmonary syndrome: ligation vs liver transplantation[Ｊ]. J Pediatr Surg, 2006; 41(2): e1e3.

1. Abernethy J. Account of two instances of uncommon formation in the viscera of the human body [Ｊ]. Phil Trans R Soc, 1793; 83: 5966.
2. 陈国庭, 李恒平. Abernethy畸形一例 [Ｊ]. 中华普通外科杂志, 2005; 20(5): 328.
3. 陈诚豪, 王大勇, 李小松, 等. 先天性肝外门腔静脉分流并下消化道出血1例 [Ｊ]. 临床小儿外科杂志, 2007; 6(2): 7879.
4. Murray CP, Yoo SJ, Babyn PS. Congenital extrahepatic portosystemic shunts [Ｊ]. Pediatr Radiol, 2003; 33(9): 614620.
5. Kumar A, Kumar J, Aggarwal R, et al. Abernethy malformation with portal vein aneurysm [Ｊ]. Diagn Interv Radiol, 2008; 14(3): 143146.
6. Oei M, Wessling J. Abernethy malformation-congenital aplasia of the portal vein a 29yearold patient [Ｊ]. Rofo, 2007; 179(2): 167169.
7. Abernethy LJ. Classification and imaging of vascular malformations in children [Ｊ]. Eur Radiol, 2003; 13(11): 24832497.
8. Howard ER, Davenport M. Congenital extrahepatic portocaval shuntsthe Abernethy malformation (Review) [Ｊ]. J Pediatr Surg, 1997; 32(3): 494497.
9. Moon SB, Park KW, Jung SE. Abnormal direct entry of the umbilical vein into the portal vein: report of a case [Ｊ]. Pediatr Surg Int, 2008; 24(11): 12431245.
10. Ringe K, Schirg E, Melter M, et al. Congenital absence of the portal vein (CAPV). Two cases of Abernethy malformation type 1 and review of the literature [Ｊ]. Radiologe, 2008; 48(5): 493502.
11. Witters P, Maleux G, George C, et al. Congenital venovenous malformations of the liver: widely variable clinical presentations [Ｊ]. J Gastroenterol Hepatol, 2008; 23(8 Pt 2): e390e394.
12. Stringer MD. The clinical anatomy of congenital portosystemic venous shunts [Ｊ]. Clin Anat, 2008; 21(2): 147157.
13. Morikawa N, Honna T, Kuroda T, et al. Resolution of hepatopulmonary syndrome after ligation of a portosystemic shunt in a pediatric patient with an Abernethy malformation [Ｊ]. J Pediatr Surg, 2008; 43(2): e35e38.
14. Emre S, Arnon R, Cohen E, et al. Resolution of hepatopulmonary syndrome after auxiliary partial orthotopic liver transplantation in Abernethy malformation. A case report [Ｊ]. Liver Transpl, 2007; 13(12): 16621668.
15. 吴继东, 汪忠镐, 王仕华, 等. 儿童肝外型门脉高压症的诊治 [Ｊ]. 中国现代手术学杂志, 2003; 7(5): 375377.
16. 王欣博, 童中勋, 刘威, 等. 门静脉海绵样变性外科治疗的研究进展 [Ｊ]. 中国普外基础与临床杂志， 2008; 15(12): 877879.
17. 盖保东, 王正峰, 刘东. 门脉高压性胃病 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(12): 880882.
18. Tercier S, Delarue A, Rouault F, et al. Congenital portocaval fistula associated with hepatopulmonary syndrome: ligation vs liver transplantation[Ｊ]. J Pediatr Surg, 2006; 41(2): e1e3.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of Lower Gastrointestinal Bleeding Caused by Abernethy Malformation

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