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.
We report a 78-year-old woman who presented with repeated tarry stools, and having lower duodenal variceal bleeding caused by portal hypertension. Endoscopic therapy had been attempted, but was impossible because the endoscope could not be inserted into the lower duodenum. Thus, the lower duodenal variceal bleeding was treated with balloon-occluded retrograde transvenous obliteration in combination with embolization using microcoils. Complete hemostasis was achieved without complications, and neither the recurrence of varices nor rebleeding has occurred for the last 3 years. A review of the English-language literature reveals only 11 such cases. The world literature is reviewed.
Tanaka
O
O
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. otanaka@bf7.so-net.ne.jp
Ohno
K
K
Ohno
T
T
Tomioka
H
H
Shimizu
S
S
Yamagami
T
T
Nishimura
T
T
D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D004386:Duodenum / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D019856:Ethanolamine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007479:Iopamidol / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000150:complications; D015642:Radiology, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media; D019856:Ethanolamine; D007479:Iopamidol