西田 修, 西川 浩史, 瀬古 修二, 塚本 隆弘, 東 克己, 浅越 健助, 大谷 由利子, 三宅 直樹, 井上 文彦, 古川 裕夫, 水本 孝

Osamu NISHIDA, Koji NISHIKAWA, Shuji SEKO, Takahiro TSUKAMOTO, Katsumi AZUMA, Kensuke ASAGOE, Yuriko OTANI, Naoki MIYAKE, Fumihiko INOUE, Hiroo FURUKAWA, Takashi MIZUMOTO

大津赤十字病院内科

Department of Internal Medicine, Otsu Red Cross Hospital

キーワード : Alcoholic liver cirrhosis, Hepatic tumor, Reverse portal flow, Ultrasonic Doppler flowmeter

Reverse portal blood flow is thought to be a rare condition. We encountered two cases of this condition and found that direction of blood flow changed with recovery of systemic condition. The first case occurred in a 61-year-old woman who had a large tumor in the right hepatic lobe. Reverse portal flow was seen in both the right and left portal veins. After TAE treatment the blood flow changed to hepatopetal in the right portal vein but remained hepatofugal in left portal vein. With improvement in general condition, however, blood flow of left portal vein became hepatopetal. The second case occurred in a 48-year-old man who had alcoholic liver cirrhosis. Severe liver damage was found at time of admission, and portal blood flow was hepatofugal; reverse portal blood flow was observed in both the portal trunk and the smaller portal branches. Again improvement in general condition was followed by a change to hepatopetal blood flow in the portal vein. Later, however, systemic condition worsened and the patient died. Reexamination of portal hemodynamics just before the patient died showed that portal blood flow had reverted to hepatofugal.