TIPS+BRTO,疏+堵双管齐下治洪血

黄明声

<h3>中年男性,肝硬化病史多年,一周前呕血约1000ml。食道胃镜显示食道胃底静脉重度曲张。</h3> <h3>上腹部CT示食道胃底静脉曲张并胃肾分流</h3> <h3>常规TIPS术,术前PPG24cm水柱</h3> <h3>明显的胃肾分流</h3> <h3>球囊扩张分流通道</h3> <h3>植入viatorr支架(8mm*7Cm),术后PPG降至7cm水柱。</h3> <h3>BRTO,球囊阻塞左肾上腺静脉(胃肾分流通道)后造影,见左心包膈静脉明显显示。</h3> <h3>将心包膈静脉栓塞后再造影,胃底曲张静脉造影剂有滞留。</h3> <h3>球囊阻塞后予以胃底静脉曲张硬化治疗</h3>