冨山 剛, 上野 規男, 田野 茂夫, 佐々木 厚博, 福田 正巳, 相澤 俊幸, 木村 健

Takeshi TOMIYAMA, Norio UENO, Shigeo TANO, Atsuhiro SASAKI, Masami FUKUDA, Toshiyuki AIZAWA, Ken KIMURA

自治医科大学消化器内科

Department of Gastroenterology, Jichi Medical School

キーワード : Superior mesenteric vein (SMV)-Inferior vena cava (IVC) shunt, Collateral, Color Doppler ultrasound

We report a rare case of the SMV-IVC shunt associated with liver cirrhosis. A 44-year-old man was admitted to our hospital because of hepatic encephalopathy. US showed a markedly dilated SMV descending to the pelvis, where it turned back, and ascended to the dorsal side under the right kidney. Color Doppler US showed adverse blood flow from the head side to the leg side in the SMV, which turend back in the pelvis and flowed into the IVC, where a turbulence waveform pattern was exhibited. The movement of the blood flow was confirmed by abdominal angiogram and the collateral vein to IVC connection was confirmed by MRI. Color Doppler US was therefore useful for diagnosing the presence of a collateral vein and for evaluating blood flow within it.