title: Successful management of duodenal varices by balloon-occluded retrograde transvenous obliteration.
abstract: We describe a case of duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration (BRTO) alone. A 63-year-old man presented with tarry stools. Computed tomography demonstrated dilated varices around the duodenum. Emergency endoscopic examination revealed varices of the second portion of the duodenum without active bleeding. There was no evidence of bleeding in the esophagus or stomach. Colonoscopy revealed no bleeding sites in the colon. On the day after admission, a superior mesenteric arteriogram obtained in the venous phase demonstrated a collateral vein from the inferior pancreaticoduodenal vein to the inferior vena cava. Retrograde venography performed via the right femoral vein confirmed that the right inferior adrenal vein was the draining vein and that the collateral vein was occluded. There were no tarry stools after BRTO. The patient was discharged 7 days after BRTO. Two months after discharge, computed tomography showed no dilated varices around the duodenum. Three months after discharge, endoscopy confirmed the absence of varices. No bleeding has been detected as of 10 months after discharge. We conclude that BRTO is an effective treatment for duodenal varices.
authors: Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors: Masahiro
authors: M
authors: Hotta
authors: Hiroshi
authors: H
authors: Yoshida
authors: Yasuhiro
authors: Y
authors: Mamada
authors: Nobuhiko
authors: N
authors: Taniai
authors: Koichi
authors: K
authors: Bando
authors: Yoshiaki
authors: Y
authors: Mizuguchi
authors: Daisuke
authors: D
authors: Kakinuma
authors: Tomohiro
authors: T
authors: Kanda
authors: Ken-ichiro
authors: K
authors: Watanabe
authors: Takashi
authors: T
authors: Tajiri
mesh_terms: D021721:Balloon Occlusion / Q000379:methods*; D003952:Diagnostic Imaging; D004386:Duodenum / Q000098:blood supply*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008297:Male; D008875:Middle Aged; D014648:Varicose Veins / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*