• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권2호
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• pp.221-225
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• 2009

저자들은 구토와 심와부 통증을 주소로 내원한 12세 여아에서 복부 전산화 단층촬영을 시행하여 급성 췌장염과 함께 동반된 비정맥 혈전증을 진단하였고, 정맥류출혈이나 비장 비대 등의 증상을 보이지 않아 보존적치료 후 추적 관찰한 증례를 경험하였기에 보고하는 바이다.

• Radiation Oncology Journal
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• 제34권3호
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• pp.168-176
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• 2016

Purpose: The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Materials and Methods: Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. Results: The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients' prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). Conclusion: RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2008년도 추계학술대회
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• pp.189-189
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• 2008

• 대한영상의학회지
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• 제81권3호
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• pp.707-713
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• 2020

간문맥 종양혈전이 있으면서 간 실질에 이상 소견이 없는 것은 매우 드문 일이다. 간에서 종양 혈전이 있는 경우 간세포암이 가장 발생률이 높으며 림프종은 감별질환으로 잘 생각되지 않는다. 림프종의 종양혈전이 간문맥을 침범한 것은 이제까지 총 네 가지 경우에서만 보고되어 있고, 모든 경우에서 종양이 혈관으로 직접 전파되거나 또는 그 외의 림프종을 시사하는 다른 병변들이 있었다. 혈관 내 대세포 림프종이 간문맥을 함께 침범한 경우, 본 케이스와 영상학적으로 비슷하게 보일 수 있으나 본 증례 보고는 혈관 내 대세포 림프종이 아니므로 제외하여 생각하였다. 미만성 거대 B세포 림프종이 간문맥에서만 발견된 무증상의 면역력이 정상인 67세 여자 환자에 대한 증례를 소개한다. 이전에 발표된 증례에서 이와 비슷한 경우는 보고된 바가 없다.

• 대한간학회지
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• 제24권4호
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• pp.424-429
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• 2018

Hepatocellular carcinoma (HCC) is the sixth most common cause of death worldwide and the main cause of primary liver cancer. The principle problem of HCC is the poor prognosis, since advanced HCC reportedly has a median survival of only 9 months. The standard therapies are sorafenib and regorafenib, but the outcomes remain unclear. We report a 60-year-old man with advanced HCC with right adrenal gland metastasis and portal vein tumor thrombosis, who showed a complete response to multiple applications of an interdisciplinary therapy.

• Investigative Magnetic Resonance Imaging
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• 제18권2호
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• pp.171-175
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• 2014

간문맥으로 파열된 췌장 가성낭종은 매우 드문 합병증이며, 자기공명영상으로 확진된 경우는 3예만 보고되어 있다. 저자들은 50세 남자 환자에서 가성낭종과 간문맥 사이에 형성된 누공을 자기공명영상을 이용하여 비침습적으로 확진한 증례를 보고한다. T2강조영상 및 자기공명 담체관조영술에서 간문맥, 상장간막정맥, 그리고 비장정맥 내에 액체신호가 보였으며, 가성낭종과 간문맥이 직접 연결된 소견을 보였다.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.264-270
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• 2023

Backgrounds/Aims: Proximal splenorenal shunt (PSRS) is a commonly performed procedure to decompress portal hypertension, in patients with refractory variceal bleed, especially in non-cirrhotic portal hypertension (NCPH). If conventional methods are hindered by any technical or pathological factors, alternative surgical techniques may be required. This study analyzes the effectiveness of various unconventional shunt surgeries performed for NCPH. Methods: A retrospective analysis of NCPH patients who underwent unconventional shunt surgeries during the period July 2011 to June 2022 was conducted. All patients were followed up for a minimum of 12 months with doppler study of the shunt to assess shunt patency, and upper gastrointestinal endoscopy to evaluate the regression of varices. Results: During the study period, 130 patients underwent shunt surgery; among these, 31 underwent unconventional shunts (splenoadrenal shunt [SAS], 12; interposition mesocaval shunt [iMCS], 8; interposition PSRS [iPSRS], 6; jejunal vein-cava shunt [JCS], 3; left gastroepiploic-renal shunt [LGERS], 2). The main indications for unconventional shunts were left renal vein aberration (SAS, 8/12), splenic vein narrowing (iMCS, 5/8), portalhypertensive vascular changes (iPSRS, 6/6), and portomesenteric thrombosis (JCS, 3/3). The median fall in portal pressure was more in SAS (12.1 mm Hg), and operative time more in JCS, 8.4 hours (range, 5-9 hours). During a median follow-up of 36 months (6-54 months), shunt thrombosis had been reported in all cases of LGERS, and less in SAS (3/12). Variceal regression rate was high in SAS, and least in LGERS. Hypersplenism had reversed in all patients, and 6/31 patients had a recurrent bleed. Conclusions: Unconventional shunt surgery is effective in patients unsuited for other shunts, especially PSRS, and it achieves the desired effects in a significant proportion of patients.

• Investigative Magnetic Resonance Imaging
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• 제23권4호
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• pp.361-366
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• 2019

Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive malignancy common in young male patient. Typical imaging features of DSRCT include multiple soft tissue masses in the peritoneal cavity, omentum, or mesentery without an organ of origin. This report presents a rare manifestation of DSRCT revealing a solitary large retroperitoneal mass with hepatic metastasis and malignant portal vein thrombosis in 70-year-old women together with the review of literature. The tumor showed a hemorrhagic and necrotic mass with peripheral portion of T2 hypo-intensity and delayed enhancement that indicated desmoplastic stroma with dense cellularity.

• 대한핵의학회지
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• 제20권2호
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• pp.101-104
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• 1986

• 한국간담췌외과학회지
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• 제27권3호
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• pp.313-316
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• 2023

Attenuated portal vein (PV) flow is challenging in pediatric liver transplantation (LT) because it is unsuitable for classic end-to-end jump graft reconstruction from a small superior mesenteric vein (SMV). We thus introduce a novel technique of an end-to-side jump graft from SMV during pediatric LT using an adult partial liver graft. We successfully performed two cases of end-to-side retropancreatic jump graft using an iliac vein graft for PV reconstruction. One patient was a 2-year-old boy with hepatoblastoma and a Yerdel grade 3 PV thrombosis who underwent split LT. Another patient was an 8-month-old girl who had biliary atresia and PV hypoplasia with stenosis on the confluence level of the SMV; she underwent retransplantation because of graft failure related to PV thrombosis. After native PV was resected at the SMV confluence level, an end-to-side reconstruction was done from the proximal SMV to an interposition iliac vein. The interposition vein graft through posterior to the pancreas was obliquely anastomosed to the graft PV. There was no PV related complication during the follow-up period. Using a jump vascular graft in an end-to-side manner to connect the small native SMV and the large graft PV is a feasible treatment option in pediatric recipients with inadequate portal flow due to thrombosis or hypoplasia of the PV.