竹内 和男^{1, 3}, 橋本 光代¹, 中島 正男^{1, 3}, 煎本 正博^{2, 3}

Kazuo TAKEUCHI^{1, 3}, Mitsuyo HASHIMOTO¹, Masao NAKAJIMA^{1, 3}, Masahiro IRIMOTO^{2, 3}

¹虎の門病院消化器科, ²虎の門病院放射線診断学科, ³沖中記念成人病研究所

¹Department of Gastroenterology,Toranomon Hospital, ²Department of Diagnostic Radiology,Toranomon Hospital, ³Okinaka Memorial Institute for Medical Research

キーワード : ultrasound, thrombus, portal vein, intrahepatic portal branch

1) We reported on several ultrasonographic findings observed in a patient with widespread intrahepatic and extrahepatic portal vein thrombosis (PVT), which was later confirmed by autopsy.
2) Ultrasonography (US) revealed echogenic vascular structures (A), corresponding to the intrahepatic portal branches, were surrounded by a hypoechoic zone (B). Thin tubular structures and/or a narrow lumen (C) were also noted in the echogenic area and low-level echoes (D) were observed in the portal trunk (PT).
3) These ultrasonographic findings were more clearly demonstrated by ultrasonograms of the liver during the autopsy. Several large branches of the intrahepatic portal vein were partially obstructed (40 ˞ 60%) by relatively organized thrombi, and both the PT and umbilical portion were almost completely obstructed by relatively fresh thrombi (d).
4) A microscopic examination revealed organized thrombi (a) and recanalization (c) in the large portal branches. Widened periportal connective tissue with edema and abundant small lymphatic vessel-like structures (b) were also noted
5) A possible connection between ultrasonographic findings (A),(B),(C) and(D) and pathological findings (a), (b), (c) and (d) respectively, is strongly suggested by this study.