論文

査読有り
2012年3月

Isolated Dissection of the Superior Mesenteric Artery After Living Donor Liver Transplantation: A Case Report

TRANSPLANTATION PROCEEDINGS
  • H. Kokai
  • ,
  • Y. Sato
  • ,
  • S. Yamamoto
  • ,
  • H. Oya
  • ,
  • T. Kobayashi
  • ,
  • T. Watanabe
  • ,
  • K. Miura
  • ,
  • K. Hatakeyama

44
2
開始ページ
588
終了ページ
590
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.transproceed.2012.01.020
出版者・発行元
ELSEVIER SCIENCE INC

Isolated dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare, particularly after living donor liver transplantation (LDLT). We experienced a case of isolated dissection of the SMA after LDLT performed in a 56-year-old man diagnosed with hepatitis B virus related cirrhosis and hepatocellular carcinoma within the Milan criteria. He had no past history of hypertension or diabetes mellitus. At 6 days after LDLT, the patient underwent an emergency portal vein thrombectomy with ligation of a huge left gastric vein shunt. Thereafter anticoagulant and antiplatelet therapy were initiated. At 12 days after LDLT, a contrast-enhanced computer assisted tomography (CT) scan revealed the presence of a thrombus in a false lumen and a thin flap enlarged in the SMA. Because he presented neither abdominal pain nor biochemical data suggesting mesenteric ischemia, he was treated with antihypertensive agents in addition to anticoagulant and antiplatelet therapy. The thrombus in the false lumen was reduced and the intimal flap in the SMA disappeared according to the results of a CT scan 4 months after LDLT. He has remained free of symptoms for 4 years. The strategy to treat isolated SMA dissection is not well established. Urgent surgery is indicated for acute symptomatic forms with a suspicion of mesenteric ischemia; conservative treatment is indicated for patients with minimal, resolving, or no pain, but requires close follow-up.

リンク情報
DOI
https://doi.org/10.1016/j.transproceed.2012.01.020
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/22410076
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000301912400074&DestApp=WOS_CPL
ID情報
  • DOI : 10.1016/j.transproceed.2012.01.020
  • ISSN : 0041-1345
  • PubMed ID : 22410076
  • Web of Science ID : WOS:000301912400074

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