Advertisement

CardioVascular and Interventional Radiology

, Volume 33, Issue 6, pp 1257–1261 | Cite as

Septic Complication After Balloon-Occluded Retrograde Transvenous Obliteration of Duodenal Variceal Bleeding

  • Thai Akasaka
  • Toshiya ShibataEmail author
  • Hiroyoshi Isoda
  • Kojiro Taura
  • Shigeki Arizono
  • Kotaro Shimada
  • Kaori Togashi
Case Report

Abstract

We report a 64-year-old woman with duodenal varices who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) complicated by intraprocedural variceal rupture. The patient developed shivering and a fever higher than 40°C 3 days after the B-RTO procedure. A blood culture grew Entereobacter cloacoe. This case represents a rare septic complication of B-RTO for duodenal varices.

Keywords

Balloon-occluded retrograde transvenous obliteration Duodenal varix Complication Sepsis 

References

  1. 1.
    Kanagawa H, Mima S, Kouyama H, Gotoh K, Uchida T, Okuda K (1996) Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration. J Gastroenterol Hepatol 11:51–58CrossRefPubMedGoogle Scholar
  2. 2.
    Hirota S, Matsumoto S, Tomita M, Sako M, Kono M (1999) Retrograde transvenous obliteration of gastric varices. Radiology 211:349–356PubMedGoogle Scholar
  3. 3.
    Fukuda T, Hirota S, Sugimura K (2001) Long-term results of balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephalopathy. J Vasc Interv Radiol 12:327–336CrossRefPubMedGoogle Scholar
  4. 4.
    Lebrec D, Benhamou J (1985) Ectopic varices in portal hypertension. Clin Gastroenterol 14:105–119PubMedGoogle Scholar
  5. 5.
    Hashizume M, Tanoue K, Ohta M et al (1993) Vascular anatomy of duodenal varices: angiographic and histopathological assessments. Am J Gastroenterol 88:1942–1945PubMedGoogle Scholar
  6. 6.
    Haruta I, Isobe Y, Ueno E et al (1996) Balloon-occluded retrograde transvenous obliteration (BRTO), a promising nonsurgical therapy for ectopic varices: a case report of successful treatment of duodenal varices by BRTO. Am J Gastroenterol 91:2594–2597PubMedGoogle Scholar
  7. 7.
    Ota K, Okazaki M, Higashihara H et al (1999) Combination of transileocolic vein obliteration and balloon-occluded retrograde transvenous obliteration is effective for ruptured duodenal varices. J Gastroenterol 34:694–699CrossRefPubMedGoogle Scholar
  8. 8.
    Ohta M, Yasumori K, Saku M (1999) Successful treatment of bleeding duodenal varices by balloon-occluded retrograde transvenous obliteration: a transjugular venous approach. Surgery 126:581–583PubMedGoogle Scholar
  9. 9.
    Sonomura T, Horihata K, Yamahara K et al (2003) Ruptured duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration: usefulness of microcatheters. Am J Roentgenol 181:725–727Google Scholar
  10. 10.
    Akazawa Y, Murata I, Yamao T et al (2003) Successful management of bleeding duodenal varices by endoscopic variceal ligation and balloon-occluded retrograde transvenous obliteration. Gastrointest Endosc 58:794–797CrossRefPubMedGoogle Scholar
  11. 11.
    Takamura K, Miyake H, Mori H et al (2005) Balloon occluded retrograde transvenous obliteration and percutaneous transhepatic obliteration for ruptured duodenal varices after operation for rectal cancer with multiple liver metastases: report of a case. J Med Invest 52:212–217CrossRefPubMedGoogle Scholar
  12. 12.
    Tsurusaki M, Sugimoto K, Matsumoto S et al (2006) Bleeding duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration (B-RTO) assisted by CT during arterial portography. Cardiovasc Interv Radiol 29:1148–1151CrossRefGoogle Scholar
  13. 13.
    Zamora CA, Sugimoto K, Tsurusaki M et al (2006) Endovascular obliteration of bleeding duodenal varices in patient with liver cirrhosis. Eur Radiol 16:73–79CrossRefPubMedGoogle Scholar
  14. 14.
    Tanaka O, Ohno K, Ohno T, Tomioka H, Shimizu S, Yamagami T, Nishimura T (2008) Should balloon-occluded retrograde transvenous obliteration be the first-line interventional radiologic treatment for bleeding duodenal varices? A case report and review of the literature. Acta Radiol 49:32–36CrossRefPubMedGoogle Scholar
  15. 15.
    Boyer TD (2003) Transjugular intrahepatic portosystemic shunt: current status. Gastroenterology 124:1700–1710CrossRefPubMedGoogle Scholar
  16. 16.
    Henderson JM, Boyer TD, Kutner MH et al (2006) Distal splenorenal shunt versus transjugular intrahepatic portal systematic shunt for variceal bleeding: a randomized trial. Gastroenterology 130:1643–1651CrossRefPubMedGoogle Scholar
  17. 17.
    Macedo TA, Andrews JC, Kamath PS (2005) Ectopic varices in the gastrointestinal tract: short- and long-term outcomes of percutaneous therapy. Cardiovasc Interv Radiol 28:178–184CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009

Authors and Affiliations

  • Thai Akasaka
    • 1
  • Toshiya Shibata
    • 1
    Email author
  • Hiroyoshi Isoda
    • 1
  • Kojiro Taura
    • 2
  • Shigeki Arizono
    • 1
  • Kotaro Shimada
    • 1
  • Kaori Togashi
    • 1
  1. 1.Department of RadiologyKyoto University Graduate School of MedicineShogoin, Sakyoku, KyotoJapan
  2. 2.Department of SurgeryKyoto University Graduate School of MedicineShogoin, Sakyoku, KyotoJapan

Personalised recommendations