経頸静脈的肝内門脈大循環短絡術により内視鏡的にportal hypertensive colopathyの改善を確認した肝硬変症の1例

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  • A Case of Portal Hypertensive Colopathy Improved after Transjugular Intrahepatic Portosystemic Shunt Therapy in Patient with Liver Cirrhosis

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A 46-year-old male with alcoholism admitted to our hospital for the rupture of esophageal varices. He was diagnosed alcoholic liver cirrhosis with esophageal varices (Cw, F2, Lm, RC (+) ) by laboratory, radiographic and endoscopic examinations. Colonoscopic findings revealed vascular ectasias, irregular vascular pattern, diffuse red spots, dilated veins and rectal varices, so we diagnosed portal hypertensive colopathy (PHC) .<br> Transjugular intrahepatic portosystemic shunt (TIPS) was performed for esophageal varices with informed consent and the approval of Ethics Comittee in Nippon Medical School, portal venous pressure was decompressed from 35.3mmHg to 22.8mmHg (35.4%) . After TIPS therapy, esophageal varices was improved to its endoscopic finding with Cw, F1, RC (-) and colonoscopic findings of PHC was also improved.<br> Portal hypertension is an important facter of etiology of PHC, we suggest that decompression of portal venous pressure induced the improvement of the vascular lesions in patient with PHC.

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