古田 清¹, 宜保 行雄¹, 今井 康晴¹, 植村 一幸¹, 清沢 研道¹, 古田 精市¹, 近藤 良明², 岡嵜 洋一², 堀米 直人³, 梶川 昌二³

Kiyoshi FURUTA¹, Yukio GIBO¹, Yasuharu IMAI¹, Kazuyuki UEMURA¹, Kendo KIYOSAWA¹, Seiichi FURUTA¹, Yoshiaki KONDO², Yooichi OKAZAKI², Naoto HORIGOME³, Shoji KAJIKAWA³

¹信州大学医学部第二内科, ²信州大学医学部放射線科, ³信州大学医学部第二外科

¹The Second Department of Internal Medicine, Shinshu University School of Medicine, ²Department of Radiology, Shinshu University School of Medicine, ³The Second Department of Surgery, Shinshu University School of Medicine

キーワード : Budd-Chiari syndrome, Ultrasonic diagnosis, Inferior right hepatic vein

Two patients with the Budd-Chiari syndrome were investigated with ultrasound. On physical examination, both cases did not show the typical superficial venous dilatation. Laboratory data for these cases gave the suspicious diagnosis of liver cirrhosis. Ultrasonic images showed the arcade between the dilated inferior right hepatic vein (IRHV) and right hepatic vein (RHV) or middle hepatic vein (MHV). These communicating veins were estimated as the bypass of the principal hepatic veins by Doppler. Obstruction of the inferior vena cava (IVC) at the diaphragma level was suspected with Doppler. Cavography and hepatic venography showed that IVC was obstructed at the diaphragma level about 2 cm in both cases and the three ordinal hepatic veins were not connected to the IVC. Large communicating veins existed between the hepatic veins and IRHV. Ultrasonography is noninvasive and useful for the diagnosis of the Budd-Chiari syndrome.