Portal venous perfusion steal causing graft dysfunction after orthotopic liver transplantation: serial imaging findings in a successfully treated patient
Ultrasonography
; : 78-82, 2016.
Article
in En
| WPRIM
| ID: wpr-731194
Responsible library:
WPRO
ABSTRACT
A 53-year-old male with hepatocellular carcinoma underwent orthotopic liver transplantation. Preoperative computed tomography revealed main portal vein luminal narrowing by flat thrombi and the development of cavernous transformation. On post-transplantation day 1, thrombotic portal venous occlusion occurred, and emergency thrombectomy was performed. Subsequent Doppler ultrasonography and contrast-enhanced ultrasonography confirmed the restoration of normal portal venous flow. The next day, however, decreased portal venous velocity was observed via Doppler ultrasonography, and serum liver enzymes and bilirubin levels remained persistently elevated. Direct portography identified massive perfusion steal through prominent splenorenal collateral veins. Stent insertion and balloon angioplasty of the portal vein were performed, and subsequent Doppler ultrasonography demonstrated normalized portal flow parameters. Afterwards, the serum liver enzymes and bilirubin levels rapidly normalized.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Perfusion
/
Phenobarbital
/
Portal Vein
/
Veins
/
Bilirubin
/
Portography
/
Portasystemic Shunt, Surgical
/
Stents
/
Ultrasonography
/
Liver Transplantation
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Humans
/
Male
Language:
En
Journal:
Ultrasonography
Year:
2016
Type:
Article