Skip to main content
SpringerLink
Log in

Percutaneous transhepatic sclerotherapy for bleeding ileal varices associated with portal hypertension and previous abdominal surgery

  • Case Report
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

A 75-year-old man with portal hypertension was referred to our institution because he suddenly began to pass a large amount of tarry stool. Arterial portography and computed tomography (CT) during arterial portography via the superior mesenteric artery, using a unified 64-slice multidetector row CT and angiography system, revealed bleeding ileal varices. The varices were supplied blood by a single ileal vein and drained by dilated veins in the abdominal wall. The bleeding was successfully arrested by performing percutaneous transhepatic sclerotherapy with 12 ml of 5% ethanolamine oleate. The blood flow to the varices was controlled by balloon occlusion, and microcoils were inserted into the varices and supplying vein. No complications or rebleeding occurred during the 13-month follow-up period, and CT images obtained during follow-up showed that the varices had disappeared.

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

Similar content being viewed by others

References

  1. Norton ID, Andrews JC, Kamath PS. Management of ectopic varices. Hepatology 1998;28:1154–1158.

    Article  CAS  PubMed  Google Scholar 

  2. Vidal V, Joly L, Perreault P, Bouchard L, Lafortune M, Pomier-Layrargues G. Usefulness of transjugular intrahepatic portosystemic shunt in the management of bleeding ectopic varices in cirrhotic patients. Cardiovasc Intervent Radiol 2006;29:216–219.

    Article  CAS  PubMed  Google Scholar 

  3. Vangeli M, Patch D, Terreni N, Tibballs J, Watkinson A, Davies N, et al. Bleeding ectopic varices: treatment with transjugular intrahepatic port-systemic shunt (TIPS) and embolization. J Hepatol 2004;41:560–566.

    Article  PubMed  Google Scholar 

  4. Haskal ZJ, Scott M, Rubin RA, Cope C. Intestital varices: treatment with the transjugular intrahepatic portsystemic shunt. Radiology 1994;191:183–187.

    CAS  PubMed  Google Scholar 

  5. Chikamori F, Kuniyoshi N, Kagiyama S, Kawashima T, Shibuya S, Takase Y. Role of percutaneous transhepatic obliteration for special types of varices with portal hypertension. Abdom Imaging 2007;32:92–95.

    Article  CAS  PubMed  Google Scholar 

  6. Ono S, Irie T, Kuramochi M, Kamoshida T, Hirai S, Oka Y. Successful treatment of mesenteric varices with balloon-occluded retrograde transvenous obliteration via an abdominal wall vein. J Vasc Interv Radiol 2007;18:1033–1035.

    Article  PubMed  Google Scholar 

  7. Zamora CA, Sugimoto K, Tsurusaki M, Izaki K, Fukuda T, Matsumoto S, et al. Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis. Eur Radiol 2006;16:73–79.

    Article  PubMed  Google Scholar 

  8. Ninoi T, Nakamura K, Kaminou T, Nishida N, Sakai Y, Kitayama T, et al. TIPS versus transcatheter sclerotherapy for gastric varices. AJR Am J Roentgenol 2004;183:369–376.

    PubMed  Google Scholar 

  9. Moncure AC, Waltman AC, Vandersalm TJ, Linton RR, Levine FH, Abbott WM. Gastrointestinal hemorrhage from adhesion-related mesenteric varices. Ann Surg 1976;183: 24–29.

    Article  CAS  PubMed  Google Scholar 

  10. L’Herminé C, Chastanet P, Delemazure O, Bonnière PL, Durieu JP, Paris JC. Percutaneous transhepatic embolization of gastroesophageal varices: results in 400 patients. AJR Am J Roentgenol 1989;152:755–760.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, 721-8511, Japan

    Toshihiro Iguchi & Daisaku Inoue

  2. Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan

    Kazuhisa Yabushita, Kohsaku Sakaguchi & Takeshi Hosoya

  3. Department of Radiology, Okayama University Medical School, Okayama, Japan

    Hidefumi Mimura & Susumu Kanazawa

Authors
  1. Toshihiro Iguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuhisa Yabushita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kohsaku Sakaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takeshi Hosoya
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daisaku Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hidefumi Mimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Susumu Kanazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshihiro Iguchi.

About this article

Cite this article

Iguchi, T., Yabushita, K., Sakaguchi, K. et al. Percutaneous transhepatic sclerotherapy for bleeding ileal varices associated with portal hypertension and previous abdominal surgery. Jpn J Radiol 28, 169–172 (2010). https://doi.org/10.1007/s11604-009-0392-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-009-0392-6

Key words

Search

Navigation