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Journal of Medical Ultrasonics

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1988 - Vol.15

Vol.15 No.06

Case Report(症例報告)

(0511 - 0517)


Ultrasonographic Diagnosis of Budd-Chiari Syndrome: A Report of Two Cases

古田 清1, 宜保 行雄1, 今井 康晴1, 植村 一幸1, 清沢 研道1, 古田 精市1, 近藤 良明2, 岡嵜 洋一2, 堀米 直人3, 梶川 昌二3

Kiyoshi FURUTA1, Yukio GIBO1, Yasuharu IMAI1, Kazuyuki UEMURA1, Kendo KIYOSAWA1, Seiichi FURUTA1, Yoshiaki KONDO2, Yooichi OKAZAKI2, Naoto HORIGOME3, Shoji KAJIKAWA3

1信州大学医学部第二内科, 2信州大学医学部放射線科, 3信州大学医学部第二外科

1The Second Department of Internal Medicine, Shinshu University School of Medicine, 2Department of Radiology, Shinshu University School of Medicine, 3The Second Department of Surgery, Shinshu University School of Medicine

キーワード : Budd-Chiari syndrome, Ultrasonic diagnosis, Inferior right hepatic vein

Two patients with the Budd-Chiari syndrome were investigated with ultrasound. On physical examination, both cases did not show the typical superficial venous dilatation. Laboratory data for these cases gave the suspicious diagnosis of liver cirrhosis. Ultrasonic images showed the arcade between the dilated inferior right hepatic vein (IRHV) and right hepatic vein (RHV) or middle hepatic vein (MHV). These communicating veins were estimated as the bypass of the principal hepatic veins by Doppler. Obstruction of the inferior vena cava (IVC) at the diaphragma level was suspected with Doppler. Cavography and hepatic venography showed that IVC was obstructed at the diaphragma level about 2 cm in both cases and the three ordinal hepatic veins were not connected to the IVC. Large communicating veins existed between the hepatic veins and IRHV. Ultrasonography is noninvasive and useful for the diagnosis of the Budd-Chiari syndrome.