Modified interventional obliteration for variceal hemorrhage from elevated jejunum after pylorus-preserving pancreatoduodenectomy

作者：Sakamoto Noriaki^*; Yamaguchi Masato; Sofue Keitaro; Muradi Akhmadu; Idoguchi Koji; Okada Takuya; Ueshima Eisuke; Sugimoto Koji

来源：Japanese Journal of Radiology, 2014, 32(8): 487-490.

DOI：10.1007/s11604-014-0318-9

• Ectopic variceal hemorrhage
• Sinistral portal hypertension
• Endovascular obliteration

Ectopic variceal hemorrhage caused by sinistral portal hypertension after splenic vein ligation during a pyloric-preserving pancreatoduodenectomy is a rare entity. We report the case of a 58-year-old man with symptoms of refractory melena. The varices could not be treated endoscopically and surgery was considered unsuitable due to severe adhesions and altered anatomy. Following clinical failure of partial splenic embolization, an alternative obliteration method by a retrograde trans-portal-venous approach was successfully performed and resolved the problem. It seems to be an effective method for ectopic variceal bleeding, especially when other interventions are unavailable or highly risky.

• 出版日期2014-8