Skip to main content
SpringerLink
Log in

Bleeding Duodenal Varices Successfully Treated with Balloon-Occluded Retrograde Transvenous Obliteration (B-RTO) Assisted by CT During Arterial Portography

  • CASE REPORT
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

A 60-year-old woman with massive hemorrhage from duodenal varices was transferred to our hospital for the purpose of transcatheter intervention. Although digital subtraction arterial portography could not depict the entire pathway of collateral circulation, the efferent route of the duodenal varices was clearly demonstrated on subsequent CT during arterial portography. Balloon-occluded retrograde transvenous obliteration (B-RTO) of the varices was performed via the efferent vein and achieved complete thrombosis of the varices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.

Similar content being viewed by others

References

  1. F Khouqeer C Morrow P Jordan (1987) ArticleTitleDuodenal varices as a cause of massive upper gastrointestinal bleeding Surgery 102 548–552 Occurrence Handle3498234 Occurrence Handle1:STN:280:DyaL2szitVWiug%3D%3D

    PubMed  CAS  Google Scholar 

  2. JR Kirkpatrick JP Shoenut AB Micflikier (1985) ArticleTitleSuccessful injection sclerotherapy for bleeding duodenal varix in intrahepatic portal obstruction Gastrointest Endosc 31 259–260 Occurrence Handle3875516 Occurrence Handle1:STN:280:DyaL2M3os1WrtA%3D%3D

    PubMed  CAS  Google Scholar 

  3. R Rai SW Panzer E Miskovsky PJ Thuluvath (1994) ArticleTitleThrombin injection for bleeding duodenal varices Am J Gastroenterol 89 1871–1873 Occurrence Handle7942686 Occurrence Handle1:STN:280:DyaK2M%2FivFWquw%3D%3D

    PubMed  CAS  Google Scholar 

  4. M Sans J Llach JM Bordas et al. (1996) ArticleTitleThrombin and ethanolamine injection therapy in arresting uncontrolled bleeding from duodenal varices Endoscopy 28 403 Occurrence Handle8813517 Occurrence Handle1:STN:280:DyaK28vgvVGisg%3D%3D

    PubMed  CAS  Google Scholar 

  5. M Shiraishi S Hiroyasu T Higa et al. (1999) ArticleTitleSuccessful management of ruptured duodenal varices by means of endoscopic variceal ligation: report of a case Gastrointest Endosc 49 255–257 Occurrence Handle9925710 Occurrence Handle1:STN:280:DyaK1M7isVKksQ%3D%3D Occurrence Handle10.1016/S0016-5107(99)70498-0

    Article  PubMed  CAS  Google Scholar 

  6. G Herold EF Stange (1993) ArticleTitleSclerotherapy of duodenal varices using a fibrin tissue sealant Endoscopy 25 371–372 Occurrence Handle8348890 Occurrence Handle1:STN:280:DyaK3szltFGksw%3D%3D

    PubMed  CAS  Google Scholar 

  7. J Tazawa Y Sakai K Koizumi et al. (1995) ArticleTitleEndoscopic ligation for ruptured duodenal varices Am J Gastroenterol 90 677–678 Occurrence Handle7717347 Occurrence Handle1:STN:280:DyaK2M3jtlekuw%3D%3D

    PubMed  CAS  Google Scholar 

  8. K Ota Z Shirai T Masuzaki et al. (1998) ArticleTitleEndoscopic injection sclerotherapy with n-butyl-2-cyanoacrylate for ruptured duodenal varices J Gastroenterol 33 550–555 Occurrence Handle9719241 Occurrence Handle1:STN:280:DyaK1czotlOhsQ%3D%3D Occurrence Handle10.1007/s005350050131

    Article  PubMed  CAS  Google Scholar 

  9. T Sauerbruch M Weinzierl HP Dietrich et al. (1982) ArticleTitleSclerotherapy of a bleeding duodenal varix Endoscopy 14 187–189 Occurrence Handle6981504 Occurrence Handle1:STN:280:DyaL3s%2FgtlGntA%3D%3D Occurrence Handle10.1055/s-2007-1021618

    Article  PubMed  CAS  Google Scholar 

  10. AW Barbish MN Ehrinpreis (1993) ArticleTitleSuccessful endoscopic injection sclerotherapy of a bleeding duodenal varix Am J Gastroenterol 88 90–92 Occurrence Handle8420280 Occurrence Handle1:STN:280:DyaK3s7ivVagug%3D%3D

    PubMed  CAS  Google Scholar 

  11. SS Jonnalagadda S Quiason OJ Smith (1998) ArticleTitleSuccessful therapy of bleeding duodenal varices by TIPS after failure of sclerotherapy Am J Gastroenterol 93 272–274 Occurrence Handle9468260 Occurrence Handle1:STN:280:DyaK1c7islOkug%3D%3D Occurrence Handle10.1111/j.1572-0241.1998.270_3.x

    Article  PubMed  CAS  Google Scholar 

  12. Y Menu B Gayet H Nahum (1987) ArticleTitleBleeding duodenal varices: diagnosis and treatment by percutaneous portography and transcatheter embolization Gastrointest Radiol 12 111–113 Occurrence Handle3493935 Occurrence Handle1:STN:280:DyaL2s7mtlWqsQ%3D%3D Occurrence Handle10.1007/BF01885117

    Article  PubMed  CAS  Google Scholar 

  13. S Hirota S Matsumoto M Tomita et al. (1999) ArticleTitleRetrograde transvenous obliteration of gastric varices Radiology 211 349–356 Occurrence Handle10228513 Occurrence Handle1:STN:280:DyaK1M3ksFWqtQ%3D%3D

    PubMed  CAS  Google Scholar 

  14. T Fukuda S Hirota K Sugimura (2001) ArticleTitleLong-term results of balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephalopathy J Vasc Interv Radiol 12 327–336 Occurrence Handle11287510 Occurrence Handle1:STN:280:DC%2BD3M3gvVSntg%3D%3D

    PubMed  CAS  Google Scholar 

  15. I Haruta Y Isobe E Ueno et al. (1996) ArticleTitleBalloon-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 2594–2597 Occurrence Handle8946993 Occurrence Handle1:STN:280:DyaK2s7gt1OmsQ%3D%3D

    PubMed  CAS  Google Scholar 

  16. M Ohta K Yasumori M Saku et al. (1999) ArticleTitleSuccessful treatment of bleeding duodenal varices by balloon-occluded retrograde transvenous obliteration: a transjugular venous approach Surgery 126 581–583 Occurrence Handle10486613 Occurrence Handle1:STN:280:DyaK1Mvhs1SltQ%3D%3D

    PubMed  CAS  Google Scholar 

  17. W Alberti (1931) ArticleTitleUber den roentgenologischen nachweis von varizen in bulbus duodeni Forsch Geb Rontgenstr 43 60–65

    Google Scholar 

  18. HB Wheeler R Warren (1957) ArticleTitleDuodenal varices due to portal hypertension from arteriovenous aneurysm Ann Surg 146 229–238 Occurrence Handle13459273 Occurrence Handle1:STN:280:DyaG1c%2FgtF2jsA%3D%3D Occurrence Handle10.1097/00000658-195708000-00012

    Article  PubMed  CAS  Google Scholar 

  19. EW Shearburn DR Cooper (1966) ArticleTitleDuodenal varices treated by portacaval shunt Arch Surg 93 425–427 Occurrence Handle5296492 Occurrence Handle1:STN:280:DyaF2s%2FgtVCksw%3D%3D

    PubMed  CAS  Google Scholar 

  20. H Kanagawa S Mima H Kouyama et al. (1991) ArticleTitleA successfully treated case of fundic varices by retrograde transvenous obliteration with balloon Nippon Shokakibyo Gakkai Zasshi 88 1459–1462 Occurrence Handle1920903 Occurrence Handle1:STN:280:DyaK38%2FhsFymsw%3D%3D

    PubMed  CAS  Google Scholar 

  21. T Sonomura K Horihata K Yamahara et al. (2003) ArticleTitleRuptured duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration: usefulness of microcatheters Am J Roentgenol 181 725–727

    Google Scholar 

  22. K Ota M Okazaki H Higashihara et al. (1999) ArticleTitleCombination of transileocolic vein obliteration and balloon-occluded retrograde transvenous obliteration is effective for ruptured duodenal varices J Gastroenterol 34 694–699 Occurrence Handle10588186 Occurrence Handle1:STN:280:DC%2BD3c%2FltlCjtQ%3D%3D Occurrence Handle10.1007/s005350050321

    Article  PubMed  CAS  Google Scholar 

  23. M Hashizume K Tanoue M Ohta et al. (1993) ArticleTitleVascular anatomy of duodenal varices: angiographic and histopathological assessments Am J Gastroenterol 88 1942–1945 Occurrence Handle8237946 Occurrence Handle1:STN:280:DyaK2c%2Fls1ehtQ%3D%3D

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Masakatsu Tsurusaki, Koji Sugimoto, Shinichi Matsumoto, Kenta Izaki, Tetsuya Fukuda, Yoshinobu Akasaka, Masahiko Fujii & Kazuro Sugimura

  2. Department of Radiology, Hyogo Medical College, 1-1 Mukogawa-cho, Nishinomiya, 663-8131, Japan

    Shozo Hirota

Authors
  1. Masakatsu Tsurusaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koji Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shinichi Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenta Izaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tetsuya Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yoshinobu Akasaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masahiko Fujii
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shozo Hirota
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kazuro Sugimura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masakatsu Tsurusaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tsurusaki, M., Sugimoto, K., Matsumoto, S. et al. Bleeding Duodenal Varices Successfully Treated with Balloon-Occluded Retrograde Transvenous Obliteration (B-RTO) Assisted by CT During Arterial Portography. Cardiovasc Intervent Radiol 29, 1148–1151 (2006). https://doi.org/10.1007/s00270-004-0189-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-004-0189-z

Search

Navigation