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.
We report a patient with duodenal varices oozing blood who had undergone low anterior resection of the rectum and resection of the liver tumor because of multiple liver metastasis from rectal cancer 80 months previously. Although endoscopic variceal ligation (EVL) was carried out for the ruptured duodenal varices, their bleeding persisted and hepatic encephalopathy also appeared. Finally, balloon occluded retrograde transvenous obliteration (BRTO) with percutaneous transhepatic obliteration (PTO) was carried out for the duodenal varices. Percutaneous transhepatic portography revealed detailed hemodynamics. Following PTO, the duodenal varices were stagnated by BRTO, and no complications were recognized. No re-bleeding episode has been observed since the treatment. In addition, the hepatic encephalopathy was also improved.
Takamura
Kazuhito
K
Department of Digestive Surgery, Ehime Prefectural Central Hospital, 83, Kasuga-cho, Matsuyama, Ehime 790-0024, Japan.
Miyake
Hidenori
H
Mori
Hiroki
H
Terashima
Yoshiyasu
Y
Ando
Tsutomu
T
Fujii
Masahiko
M
Tashiro
Seiki
S
Shimada
Mitsuo
M
D000328:Adult; D021721:Balloon Occlusion; D004386:Duodenum / Q000098:blood supply*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D012004:Rectal Neoplasms / Q000150:complications / Q000601:surgery*; D012422:Rupture, Spontaneous / Q000628:therapy; D014648:Varicose Veins / Q000209:etiology / Q000628:therapy*