title: Effect of a portal venous stent for gastrointestinal hemorrhage from jejunal varices caused by portal hypertension after pancreatoduodenectomy.
abstract: We report herein the case of a 64-year-old man successfully treated by portal venous stent placement for repeated gastrointestinal bleeding associated with jejunal varices. He was admitted to our hospital with melena 8 years after having a pancreatoduodenectomy for carcinoma of the papilla of Vater. From portogram findings showing severe portal vein (PV) stenosis and dilated collaterals through the jejunal vein of the Roux-en-Y loop, jejunal varices resulting from PV stenosis were suspected as the cause of the melena. A metallic stent was placed in the PV following percutaneous transhepatic PV angioplasty. Although the cure of hemorrhagic jejunal varices caused by PV stenosis is difficult in patients who have undergone major abdominal surgery, patency of the stent in this patient has been maintained for 32 months without gastrointestinal hemorrhage. Metallic stent placement is recommended as a useful treatment for PV stenosis that is less invasive than open surgery.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
authors.forename: Shigeyasu
authors.initials: S
authors.lastname: Ota
authors.forename: Shohachi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsuoka
authors.forename: Naoki
authors.initials: N
authors.lastname: Unno
authors.forename: Shoichi
authors.initials: S
authors.lastname: Inagawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007583:Jejunum / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011169:Portal Vein; D011172:Portography; D015607:Stents