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Surgery Today

, Volume 40, Issue 8, pp 788–791 | Cite as

Successful embolization therapy for bleeding from jejunal varices after choledochojejunostomy: Report of a case

  • Akitoshi Sasamoto
  • Junichi Kamiya
  • Yuji Nimura
  • Masato Nagino
Case Report

Abstract

We report a case of successful embolization of jejunal varices that were the cause of massive gastrointestinal bleeding from a choledochojejunostomy site, resulting from obstruction of the extrahepatic portal vein. A 42-year-old man who had undergone choledochojejunostomy for intrahepatic and choledochal stones was readmitted after he started passing massive dark bloody stools. Gastrointestinal endoscopic examination and angiography could not identify the source of bleeding. Percutaneous transhepatic portography showed obstruction of the right branches of the portal vein. The formation of jejunal varices at the site of choledochojejunostomy was revealed by portography and by cholangioscopy, suggesting the varices as the cause of massive bleeding. Bleeding could not be controlled long-term by cholangioscopic sclerosing therapy. We finally stopped the bleeding by embolizing a jejunal vein to the afferent loop.

Key words

Jejunal varices Choledochojejunostomy Gastrointestinal bleeding 

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Copyright information

© Springer 2010

Authors and Affiliations

  • Akitoshi Sasamoto
    • 1
  • Junichi Kamiya
    • 2
  • Yuji Nimura
    • 3
  • Masato Nagino
    • 4
  1. 1.Department of SurgeryShizuoka Kosei HospitalShizuokaJapan
  2. 2.Department of SurgeryToyota Kosei HospitalToyotaJapan
  3. 3.Department of SurgeryAichi Cancer CenterNagoyaJapan
  4. 4.Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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