Abstract
A 44-year-old man with cirrhosis arising from alcohol abuse manifested melena caused by the rupture of esophageal varices. He received endoscopic variceal ligation for the initial hemostasis, followed by endoscopic injection sclerotherapy as an additional consolidation therapy. A CT examination performed at the time of admission revealed collateral veins developing around the ascending colon, in which the feeding and draining vessels were identified as the superior mesenteric vein and the right testicular vein, respectively. Moreover, large nodular varices were observed in the ascending colon during a colonoscopy. To prevent the rupture of the colonic varices, balloon-occluded retrograde transvenous obliteration (B-RTO) was performed through the right testicular vein using a microballoon catheter. A CT examination performed 4 days after the B-RTO procedure revealed the disappearance of blood flow with thrombosis formation in both the colonic varices and the feeding vein. The varices in the ascending colon had completely disappeared when examined during a colonoscopy performed 4 months after the B-RTO procedure. B-RTO is a useful and minimally invasive procedure for the treatment of colonic varices to prevent bleeding.
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Satoshi Mochida has received research grants, speaking fees or honoraria from Ajinomoto Co., Inc., Bristol-Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd, Sumitomo Dainippon Pharma Co., Ltd., Eisai Co., Ltd. Mitsubishi Tanabe Pharma Co., MSD K.K., Gilead Sciences Inc., Abbvie Inc., A2 Healthcare Corp., and Toray Industries, Inc.
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All procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Matsumoto, K., Imai, Y., Takano, M. et al. A case of colonic varices complicated by alcoholic cirrhosis treated using balloon-occluded retrograde transvenous obliteration. Clin J Gastroenterol 11, 343–347 (2018). https://doi.org/10.1007/s12328-018-0857-1
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DOI: https://doi.org/10.1007/s12328-018-0857-1