Atsumasa KOMORI^{1, 3}, Chuu KATAOKA¹, Seiichi OKAMURA¹, Kazuo TANOUE², Makoto HASHIZUME¹, Yasunori ICHIKI^{1, 3}, Tomoko TAKASAKI¹, Hirohisa SHIGEMATSU¹, Kazuhiro HAYASHIDA¹, Hiromi ISHIBASHI¹

¹First Department of Internal Medicine, Kyushu University Faculty of Medicine, ²Second Department of Surgery, Kyushu University Faculty of Medicine, ³Department of Internal Medicine, Oita Red Cross Hospital

キーワード : Doppler imaging, Idiopathic portal hypertension, Intrahepatic portosystemic venous shunt

We used computed-tomography, three-dimensional power Doppler flow imaging, percutaneous transhepatic portography, and histology to examine a 55-year-old Japanese woman with an enormous aneurysmal intrahepatic portosystemic venous shunt (IPVS) associated with idiopathic portal hypertension (IPH) and rheumatoid arthritis. The patient showed clinical evidence of portal hypertension but had neither episodes of hepatic encephalopathy nor risky esophagogastric varices. The intrahepatic venous shunting may have had a therapeutic effect on her portal hemodynamics, thereby preventing formation of risky varices. To our knowledge, this is the first reported case of definite IPH accompanied by an aneurysmal IPVS. Three dimensional power Doppler flow imaging using a magnetic field was useful in reconstructing the 3D image of the aneurysmal IPVS.