Successful treatment of bleeding due to ileal varices in a patient with hepatocellular carcinoma.
This case report concerns a 62-year-old female who was known to have cirrhosis. An endoscopic examination showed no evidence of haemorrhaging due to either oesophageal or gastric varices. Angiographic studies demonstrated extravasation from the ileal varices. There was a prominent arterio-portal shunt in the liver, and the shunt was considered to be a contributing factor to induce portal hypertension and variceal bleeding in the ileum. Therefore, transcatheter arterial embolization was performed, but was unsuccessful. As a result, the patient underwent a laparotomy, and a dilatating ileocaecal vein and a communicating ovarian vein were selectively ligated. Following the procedure, the haemorrhaging stopped and she then recovered. The patient is doing well 21 months after surgery at the time of writing.
Kobayashi
K
K
Department of Surgery, National Saga Hospital, Japan.
Yamaguchi
J
J
Mizoe
A
A
Isomoto
I
I
Koshiishi
T
T
Izawa
K
K
Kanematsu
T
T
D006528:Carcinoma, Hepatocellular / Q000150:complications*; D004108:Dilatation, Pathologic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007082:Ileum / Q000098:blood supply*; D008026:Ligation; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000150:complications*; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D014463:Ultrasonography; D014648:Varicose Veins / Q000150:complications*