Portal vein invasion and cavernous transformation secondary to hepatic echinococcosis successfully managed by TIPS: a case report and literature review.

IF 0.8 Q4 GASTROENTEROLOGY & HEPATOLOGY

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-08-08 DOI:10.1007/s12328-026-02418-w

Bao Yingjun, Zhang Yuan, Zhu Diwen, Gu Junpeng, Ren Weixin

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引用次数: 0

Abstract

Background: Hydatid disease is a zoonotic parasitic disease caused by Echinococcus larvae, with hepatic echinococcosis sometimes exhibiting malignant-like behavior including vascular invasion. Portal vein invasion is a rare complication, and no prior report has described gastrointestinal hemorrhage due to portal hypertension from hydatid-induced portal vein invasion and cavernous transformation successfully treated by transjugular intrahepatic portosystemic shunt (TIPS).

Case presentation: A 44-year-old female with recurrent gastrointestinal bleeding and a history of right hepatectomy for hepatic alveolar echinococcosis was admitted. CT and ultrasound revealed portal vein invasion and cavernous transformation. TIPS was successfully performed, reducing the portosystemic pressure gradient from 22 mmHg to 9 mmHg.

Discussion: Hepatic echinococcosis may cause portal vein invasion and cavernous transformation. Medical therapy is poorly effective for severe complications like gastrointestinal hemorrhage. TIPS plays an important role in managing such patients.

Conclusions: Portal hypertension-related complications are rare but challenging in echinococcosis treatment. TIPS is an effective option for patients with gastrointestinal bleeding, even in the setting of portal vein invasion and cavernous transformation.

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TIPS成功治疗肝包虫病继发的门静脉侵犯和海绵样变性1例报告并文献复习。

背景：包虫病是一种由棘球蚴幼虫引起的人畜共患寄生虫病，肝棘球蚴病有时表现出恶性样行为，包括侵犯血管。门静脉侵犯是一种罕见的并发症，以前没有报道过通过经颈静脉肝内门静脉分流术（TIPS）成功治疗由包虫病引起的门静脉侵犯和海绵状转化引起的门静脉高压导致的胃肠道出血。病例介绍：一名44岁女性，因反复消化道出血，有肝肺泡包虫病右肝切除术史。CT及超声示门静脉浸润及海绵样变性。TIPS操作成功，将门静脉系统压力梯度从22 mmHg降至9 mmHg。讨论：肝包虫病可引起门静脉侵犯和海绵状变性。对于胃肠道出血等严重并发症，药物治疗效果不佳。TIPS在管理这类患者方面发挥着重要作用。结论：门脉高压相关并发症在包虫病治疗中是罕见的，但具有挑战性。TIPS对于消化道出血患者是一种有效的选择，即使在门静脉侵犯和海绵状变性的情况下也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

182

期刊介绍： The journal publishes Case Reports and Clinical Reviews on all aspects of the digestive tract, liver, biliary tract, and pancreas. Critical Case Reports that show originality or have educational implications for diagnosis and treatment are especially encouraged for submission. Personal reviews of clinical gastroenterology are also welcomed. The journal aims for quick publication of such critical Case Reports and Clinical Reviews.