원저 : Budd - Chiari 증후군의 치료로서 경피적 경혈관 풍선성형술의 유용성 ( Original Articles : The Usefullness of Percutaneous Transluminal Balloon Angioplasty in the Management of Budd - Chiari Syndrome ) |
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The Usefullness of Percutaneous Transluminal Balloon Angioplasty in the Management of Budd - Chiari Syndrome |
Se Hwan Kim, M.D., Kyung Sool Yu, M.D., Seung Min Baek, M.D.,
Seung Yup Lee, M.D., Hyun Su Kim, M.D., Won Young Tak, M.D.*,
Young Oh Kweon, M.D.*, Sung Kook Kim, M.D.*,
Yong Hwan Choi, M.D.*, and Joon Mo Chung, M.D.* |
Department of Internal Medicine, Fatima Hospital, Daegu, Korea
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea* |
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ABSTRACT |
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Background/Aims Membranous obstruction is the most common cause of Budd-Chiari syndrome in Orientals. Recently, percutaneous transluminal balloon angioplasty (PTBA) has been successfully applied as a treatment of membranous obstruction. We evaluated etiologies and clinical manifestations in our cases and the usefulness of PTBA. Methods: Twelve cases of Budd-Chiari syndrome were analyzed. Results: 50.3 years was the average age of the cases (ranging from 37 to 67 years). Major symptoms or signs were superficial collateral vessels on the chest or the abdomen in 6 cases, ascites in 3, abdominal pain in 4, hepatomegaly in 4, splenomegaly in 3, melena or hematemesis in 2, and leg edema in 2. Upper gastrointestinal endoscopy showed esophageal varices in 6 cases and two of these 6 cases had gastric varices. Of 8 cases with liver cirrhosis, 4 were classified as Child-Pugh class A and 4 as B. Four patients with cirrhosis had concurrent hepatocellular carcinoma including 1 patient who was HBs Ag positive. Etiologies were membranous obstruction in 11 cases and protein C deficiency in 1 case. The main site of obstruction was IVC in 8 and hepatic vein in 4. PTBA was successfully performed in 8 cases of membranous obstruction. During the mean follow-up period of 27.6 months (12-40 months), there were no reobstructions except in 2 cases. Conclusions: The most common cause of Budd-Chiari syndrome in our cases was membranous obstruction of IVC. Percutaneous transluminal balloon angioplasty is a very useful treatment method.(Korean J Hepatol 2002;8:179-188) |
KeyWords:
Budd-Chiari Syndrome, Percutaneous Transluminal Balloon Angioplasty |
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