[Diagnosis and treatment of membraneous obstruction of the inferior vena cava].

From 1984 to 1989, 52 cases with Budd-Chiari syndrome were surgically treated at the PUMC Hospital. Among them there were 31 cases of membranous obstruction of the inferior vena cava (MOVC, 59.6%). There were 24 males and 7 females, ase ranging from 24 to 36 years. Diagnosis was confirmed by inferior venocavagraphy. According to Sugiura's Classification, there were type Ia and Ib in 26 cases, and type II in 5. Edema and varicosity on both legs, the chest, the abdomen, and the back were found in 93.5% (29/31), and hepatomegaly, splenomegaly, and large amount of ascites were found in 61.3% (19/31), 64.5% (20/31), and 54.8% (17/31), respectively. Transcardiac membranotomy was performed in 27 cases, and the remaining 4 cases were treated by percutaneous transluminal angioplasty using balloon catheters both without operative mortality. Four to sixty months' follow-up in 29 cases revealed satisfactory results. The authors belief that membranotomy can be successfully performed in cases of MOVC when the stricture is located well above the level of T-9th vertebra, and with a length of less than 2 cm.