title: Retrograde Stenting Under Transmesenteric Angiographic Guidance of an Occluded Superior Mesenteric Vein to Treat Life-Threatening Hemorrhage.
abstract: Midgut carcinoid tumors (MCTs) are responsible for a range of mesenteric vascular complications and may rarely manifest with gastrointestinal (GI) hemorrhage. Endovascular approaches are particularly useful for this population, as surgery is often technically difficult. We report a case of life-threatening upper GI bleeding in a 50-year-old man previously diagnosed with an MCT in the small bowel mesentery. Computed tomography angiogram revealed an MCT obstructing the superior mesenteric vein (SMV) associated with multiple large collateral vessels. The patient underwent retrograde stenting of the obstructed SMV using a combined open and endovascular approach to successfully terminate the persistent GI bleeding.
authors.affiliation: Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, England. Electronic address: arun.kelay@nhs.net.
authors.forename: Arun
authors.initials: A
authors.lastname: Kelay
authors.affiliation: Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, England.
authors.forename: Luke
authors.initials: L
authors.lastname: Morgan-Rowe
authors.affiliation: Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, England.
authors.forename: Jason
authors.initials: J
authors.lastname: Constantinou
authors.affiliation: Centre for Hepatic-Pancreatic-Biliary Surgery, The Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, London, England.
authors.forename: Massimo
authors.initials: M
authors.lastname: Malago
authors.affiliation: Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, England.
authors.forename: Krassi
authors.initials: K
authors.lastname: Ivancev
mesh_terms: D002276:Carcinoid Tumor / Q000150:complications* / Q000175:diagnosis; D003097:Collateral Circulation; D057510:Endovascular Procedures / Q000295:instrumentation*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008642:Mesenteric Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D013152:Splanchnic Circulation; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome