多囊肾压迫所致布加综合征1例

A Case of Budd-Chiari Syndrome Due to Compression of Polycystic Kidney Disease

一名73岁患多囊肾的终末期肾脏病(ESRD)患者,由于“腹胀伴四肢乏力、纳差”入院,反复大量腹水,给予腹水引流、纠正白蛋白、抗感染等对症治疗效果不佳,肝静脉CTV:多囊肝、多囊肾;下腔静脉肝段明显变细、缩窄,考虑布加综合征可能;进一步下腔静脉DSA:下腔静脉肝上段明显狭窄,余未见明显狭窄及充盈缺损;球囊扩张后恢复不明显,遂狭窄部分植入支架1枚后复查DSA,显示下腔静脉显影通畅。患者术后未再出现新增腹水,1周后症状好转,于手术后10天出院。随访4周未再见明显大量腹水情况出现。

A 73-year-old end-stage renal disease (ESRD) patient with polycystic kidney disease was admitted to the hospital with “abdominal distension with weakness of limbs and poor appetite”, repeated massive ascites, and was given symptomatic treatments such as drainage of ascites, correction of albumin, and anti-infection, which were ineffective. Budd-Chiari syndrome was considered;further DSA of inferior vena cava: obvious stenosis in the hepatic segment of the inferior vena cava, no obvious stenosis and filling defects were seen in the rest of the segment;the recovery was not obvious after balloon dilatation, and DSA was repeated after implantation of 1 stent in the stenotic segment, which showed that the inferior vena cava was patent. The patient did not experience any new ascites after the operation, and was discharged 10 days after the operation after 1 week of symptomatic improvement. The patient was discharged 10 days after the operation. 4 weeks of follow-up did not see any significant amount of ascites.