Percutaneous transsplenic embolization of jejunal varices in a patient with liver cirrhosis: A case report

Department of Radiology, Hanyang University Hospital, 17 Haengdang-dong, Sungdong-gu, Seoul, 133-792, Korea.
Abdominal Imaging (Impact Factor: 1.63). 04/2012; 38(1). DOI: 10.1007/s00261-012-9894-2
Source: PubMed


Bleeding jejunal varices are rare and could be life threatening. They are usually found in the presence of portal hypertension and prior history of gastrointestinal surgery. They can be effectively managed by radiological interventions such as transjugular intrahepatic portosystemic shunt or transhepatic embolization of varices. However, in patients with portal vein obstruction, an alternative access is necessary. We report a case of bleeding jejunal varices associated with postoperative adhesion in a patient with portal vein thrombosis which was successfully managed by percutaneous transsplenic embolization.

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    Preview · Article · Mar 2014 · The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
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    ABSTRACT: Acquired portal vein (PV) stenosis or occlusion is most commonly seen after liver transplantation. In the nontransplant population, PV stenosis or occlusion can occur with pancreatitis, tumor encasement, and postsurgical complications. Portal hypertension resulting from PV stenosis or occlusion can cause variceal bleeding in the gastrointestinal tract. Bleeding from ectopic varices, such as duodenum, jejunum, ileum, and rectum, is rare and can be life threatening in patients with portal hypertension. There are several treatment options for the management of PV stenosis or occlusion combined with variceal bleeding such as PV stenting, transjugular intrahepatic portosystemic shunt (TIPS) and transhepatic or transsplenic embolization of varices. Herein we report a case of jejunal variceal bleeding with postoperative PV occlusion successfully managed by PV stent-graft placement and variceal embolization.
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