腹部造影超音波検査が有用であった生体肝移植後門脈体循環の盗血の1例

抄録

A portosystemic shunt remaining after a living-donor liver transplantation sometimes causes a postoperative portal venous flow drop. It is diagnosed with Doppler ultrasound, angiography, contrast-enhanced computed tomography or magnetic resonance angiography. We report a case in which a contrast-enhanced ultrasound was useful to find out a portosystemic shunt. The patient is an 8-year-old girl who had undergone a portoenterostomy for biliary atresia and a living-donor liver transplantation for a hepatopulmonary syndrome at that age of 8 years. Because of an ABO incompatible transplant, a catheter was inserted into the portal vein for local infusion therapy. At first, a Doppler ultrasound showed a normal portal venous flow. On the next day of removal of the portal venous catheter, however, her portal venous flow was not able to be confirmed. We supposed a portal thrombosis, but we were unable to confirm it by the contrast-enhanced CT scan. After a contrast-enhanced ultrasound was performed, we could confirm the portal venous flow and the steal of the portal blood through the remaining portosystemic shunt. In conclusion, a contrast-enhanced ultrasound is useful for the blood flow evaluation after a living-donor liver transplantation.