본문 바로가기
KERD
논문KCI 등재

A case report of bleeding from duodenal varices treated with percutaneous transhepatic obliteration

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

초록

Duodenal varices are ectopic in nature and account for 40% of all ectopic bleeding cases. Ectopic variceal bleeding is rare (1%–5% of all variceal bleeding cases). The three principle approaches used to treat duodenal varices are endoscopic procedures, interventional radiological methods, and surgical interventions. A 59-year-old male with alcoholic liver cirrhosis and chronic hepatitis B infection visited our gastroenterology department with melena. Gastroduodenoscopy and computed tomography identified varices in the second part of the duodenum. We performed percutaneous transhepatic obliteration using glue and coil embolization, which obliterated the varices and resulted in immediate hemostasis. However, 3 months later, he re-visited presenting with newly developed duodenal varices and underwent endoscopic injection sclerotherapy.

Abstract

Duodenal varices are ectopic in nature and account for 40% of all ectopic bleeding cases. Ectopic variceal bleeding is rare (1%–5% of all variceal bleeding cases). The three principle approaches used to treat duodenal varices are endoscopic procedures, interventional radiological methods, and surgical interventions. A 59-year-old male with alcoholic liver cirrhosis and chronic hepatitis B infection visited our gastroenterology department with melena. Gastroduodenoscopy and computed tomography identified varices in the second part of the duodenum. We performed percutaneous transhepatic obliteration using glue and coil embolization, which obliterated the varices and resulted in immediate hemostasis. However, 3 months later, he re-visited presenting with newly developed duodenal varices and underwent endoscopic injection sclerotherapy.

참고문헌 (19)

  1. Tanaka O, "Should balloon-occluded retrograde transvenous obliteration be the first-line interventional radiologic treatment for bleeding duodenal varices? A case report and review of the literature", Acta Radiol, 49, pp.32~36 (2008)
  2. Lebrec D, "Ectopic varices in portal hypertension", Clin Gastroenterol, 14, pp.105~121 (1985)
  3. Norton ID, "Management of ectopic varices", Hepatology, 28, pp.1154~1158 (1998)
  4. Perera MT, "Life-threatening bleeding from duodenal varices due to pancreatic arterio-venous malformation : role of emergency pancreatoduodenectomy", Hepatogastroenterology, 55, pp.1553~1556 (2008)
  5. Sarin SK, "Ectopic varices", Clin Liver Dis, 1, pp.167~172 (2012)
  6. Hashizume M, "Vascular anatomy of duodenal varices : angiographic and histopathological assessments", Am J Gastroenterol, 88, pp.1942~1945 (1993)
  7. Sato T, "Clinicopathological features and treatment of ectopic varices with portal hypertension", Int J Hepatol, 2011, pp.960720~ (2011)
  8. Sukigara M, "Bleeding varices located in the second portion of the duodenum", Jpn J Surg, 17, pp.130~135 (1987)
  9. Weishaupt D, "Detecting bleeding duodenal varices with multislice helical CT", AJR Am J Roentgenol, 178, pp.399~401 (2002)
  10. Liu Y, "Clinical characteristics and endoscopic treatment with cyanoacrylate injection in patients with duodenal varices", Scand J Gastroenterol, 44, pp.1012~1016 (2009)
  11. Vangeli M, "Bleeding ectopic varices--treatment with transjugular intrahepatic porto-systemic shunt(TIPS)and embolisation", J Hepatol, 41, pp.560~566 (2004)
  12. Saad WE, "Management of bleeding duodenal varices with combined TIPS decompression and Trans-TIPS transvenous obliteration utilizing 3% sodium tetradecyl sulfate foam sclerosis", J Clin Imaging Sci, 4, pp.67~ (2014)
  13. LaBerge JM, "Two-year outcome following transjugular intrahepatic portosystemic shunt for variceal bleeding : results in 90 patients", Gastroenterology, 108, pp.1143~1151 (1995)
  14. ter Borg PC, "Transjugular intrahepatic portosystemic shunts : long-term patency and clinical results in a patient cohort observed for 3-9 years", Radiology, 231, pp.537~545 (2004)
  15. Ninoi T, "Balloonoccluded retrograde transvenous obliteration of gastric varices with gastrorenal shunt : long-term follow-up in 78 patients", AJR Am J Roentgenol, 184, pp.1340~1346 (2005)
  16. 황순우, "Long-term Successful Treatment of Massive Distal Duodenal Variceal Bleeding with Balloon-occluded Retrograde Transvenous Obliteration", 대한소화기학회지, 63(4), pp.248~252 (2014), 대한소화기학회
  17. Tominaga K, "Combined balloon-occluded embolization for treatment of concurrent duodenal, gastric, and esophageal varices : a case report", Gastrointest Endosc, 53, pp.665~668 (2001)
  18. Takamura K, "Balloon occluded retrograde transvenous obliteration and percutaneous transhepatic obliteration for ruptured duodenal varices after operation for rectal cancer with multiple liver metastasis : report of a case", J Med Invest, 52, pp.212~217 (2005)
  19. Smith-Laing G, "Role of percutaneous transhepatic obliteration of varices in the management of hemorrhage from gastroesophageal varices", Gastroenterology, 80, pp.1031~1036 (1981)

이 간행물의 다른 논문 (5건)