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目的为调查肝外门静脉梗阻(EHPO)的解剖特点以澄清其病因。 方法:1985～1995年治疗10例EHPO患儿,男女各5例,年龄1～7岁,平均4.2岁。均有食管静脉曲张出血,经门静脉造影证实EHPO,并排除出生前感染、脐炎、换血,出生后因先天胆道或其他异常作手术或肝功能障碍。以实时超声检查10例患儿的门静脉,注射前列腺素E1以提高门脉血流,之后肠系膜上动脉内注入对比剂进行静脉造影检查,评定肝外、肝内相应的门静脉。静脉注射0.5ml/kg碘沙酸后行CT检查6例,并分析门静脉与胆总管之间的解剖关系。门静脉MRI检查4例,在矢状及5mm厚冠状层获得门静脉T_1加权旋转像。 结果:门静脉造影见10例患儿在肝十二指肠韧带水平肝外门脉系统弯曲成η形,肝内门静脉呈网状表现,门静脉无血栓形成。受检的6例患儿胆道CT示门静脉在胆总管左侧并跨过胆
Objective To investigate the anatomic features of extrahepatic portal vein obstruction (EHPO) to clarify its etiology. Methods: From 1985 to 1995, 10 children with EHPO were treated. There were 5 males and 5 females, aged from 1 to 7 years with an average of 4.2 years. Esophageal varices were bleeding, confirmed by portal vein angiography EHPO, and rule out prenatal infection, omphalitis, blood transfusion, after birth due to innate biliary or other abnormalities for surgery or liver dysfunction. Real-time ultrasound examination of 10 cases of children with portal vein, injection of prostaglandin E1 to increase portal blood flow, after superior mesenteric artery contrast agent for venography, assessment of extrahepatic and hepatic portal vein. Intravenous injection of 0.5ml / kg iodine acid in 6 cases after CT examination, and analysis of the portal vein and the common bile duct between the anatomy. Portal vein MRI examination in 4 cases, in the sagittal and 5 mm thick coronary T_1 weighted rotation. Results: In 10 cases of portal vein angiography, the extrahepatic portal system in the level of the hepatoduodenal ligament was bent into an eta-shape. The intrahepatic portal vein showed a reticular pattern and the portal vein had no thrombosis. Six patients undergoing biliary CT showed portal vein in the left common bile duct and across the gallbladder