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Rescue therapy for bleeding ectopic ileal varices with a transjugular intrahepatic portosystemic shunt and antegrade variceal embolization

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초록

Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.

Abstract

Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.

참고문헌 (8)

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  4. Sato T, "Treatment of ectopic varices with portal hypertension", World J Hepatol, 7, pp.1601~1605 (2015)
  5. Hashimoto N, "The efficacy of balloon-occluded retrograde transvenous obliteration on small intestinal variceal bleeding", Surgery, 148, pp.145~150 (2010)
  6. Vangeli M, "Bleeding ectopic varices--treatment with transjugular intrahepatic porto-systemic shunt(TIPS)and embolisation", J Hepatol, 41, pp.560~566 (2004)
  7. Miyayama S, "Balloon-occluded retrograde transvenous obliteration for six consecutive patients with duodenal varices", Int J Gastrointest Interv, 11, pp.13~17 (2022)
  8. Kim HC, "Interventional radiology for bleeding ectopic varices : individualized approach based on vascular anatomy", Radiographics, 44, pp.e230140~ (2024)

관련 논문AI추천

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