山本 宏¹, 安田 是和¹, 落合 聖二¹, 中田 雅敏¹, 柏井 昭良¹, 金澤 暁太郎¹, 伊東 紘一²

Hiroshi YAMAMOTO¹, Yoshikazu YASUDA¹, Seiji OCHIAI¹, Masatoshi NAKATA¹, Akiyoshi KASHII¹, Kyotaroh KANAZAWA¹, Kouichi ITOH²

¹自治医科大学消化器・一般外科, ²自治医科大学臨床病理学

¹Department of Surgery, Jichi Medical School, ²Department of Clinical Pathology, Jichi Medical School

キーワード : Idiopathic portal hypertension, Portal vein thrombosis, Hepatic ischemia, Ultrasound

A 35-year-old female underwent the Hassab's operation for symptomatic idiopathic portal hypertension. Preoperative ultrasonography (US) demonstrated the dilated portal vein. The patient developed fever and her platelet count was over 1000,000 /mm³ on the 9th postoperative day. US demonstrated a few hyperechoic mural masses attached in the portal vein. An oval lucent area demonstrated in the right lobe of the liver by both CT and US was diagnosed as hepatic ischemic change due to portal vein thrombosis. US would delineate an apparent disappearance of thrombi by anticoagulant therapy. We recommend routine application of this device to check possible portal vein thrombosis after surgery in the region.