title: Treatment of bleeding rectal varices with transumbilical venous obliteration of the inferior mesenteric vein.
abstract: A 56-year-old male with alcohol-induced liver cirrhosis developed rectal varices. He had a prior history of treatment for esophageal varices with endoscopic variceal ligation. Despite the repeated treatment for rectal varices with endoscopic variceal ligation, endoscopic injection sclerotherapy, and surgery, the bleeding from the rectal varices could not be controlled. Multidetector-row computed tomography and 3D-angiography revealed the hemodynamic profile of the rectal varices. We next approached the rectal varices through the umbilical vein on the abdominal wall, and successfully embolized the varices continuing from the inferior mesenteric vein using coils and a 5% solution of ethanolamine oleate with iopamidol.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan. naotakak@surg2.med.kyushu-u.ac.jp
authors.forename: Naotaka
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Akahoshi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kamori
authors.forename: Morimasa
authors.initials: M
authors.lastname: Tomikawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshida
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nagao
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Morita
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009829:Oleic Acids / Q000008:administration & dosage*; D012002:Rectal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000379:methods*; D014471:Umbilical Veins; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate