title: 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.
abstract: 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.
authors.affiliation: Department of Digestive Surgery, Ehime Prefectural Central Hospital, 83, Kasuga-cho, Matsuyama, Ehime 790-0024, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Takamura
authors.forename: Hidenori
authors.initials: H
authors.lastname: Miyake
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Terashima
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ando
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fujii
authors.forename: Seiki
authors.initials: S
authors.lastname: Tashiro
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
mesh_terms: 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*