Percutaneous Balloon Membranotomy로 성공적으로 치료된 하대정맥 (下大靜脈) 막성폐쇄 (膜性閉鎖) = A Case of Membranous Obstruction of the Inferior Vena Cava ( MOVC ) Successfully Treated by Balloon MemBranotomy

다국어 초록 (Multilingual Abstract)

Idiopathic membranous obstruction of the inferior vena cava (MOVC) is the most common cause of hepatic outflow obstruction world-wide, especially among Orientals, and this lesion at its hepatic portion might be one of the common cause of portal hypertension in Korea, though having not been reported till now. Most of the symptoms and signs of the MOVC are those referable to portal hypertension, collateral circulation being the most prominent feature. Distribution and direction of collaterals of MOVC are, however, different from those observed in other causes of portal hypertension in that the collateral veins channels carry blood up-words to reach the superior vena caval system. So, large truncal collateral vessels, particulary on the back, strongly suggest MOVC. Final cliagnosis of MOVC comes from inferior vena caval catheterization and angiography using two catheters simultaneously inserted through the basilic and femoral vein by demonstrating web-like membranous structure in the IVC. The classical therapeutic approach has been transcardiac membranotomy by means of finger fracture technique, but percutaneous translumina1 angioplasty using balloon catheter has recently been recommended before proceeding to operative treatment because of its simplicity and safety. We have recently been confronted by one case of idiopathic membranous obstruction of the inferior vena cava (MOVC) that was successfully managed by percutaneous balloon membranotomy, which has prompted this report with a review of this relatively rare condition.