title: Epiploic gonadal vein as a new bypass route for extrahepatic portal venous obstruction: report of a case.
abstract: A 61-year-old man was referred to our hospital to treat extrahepatic portal venous obstruction. Endoscopic injection sclerotherapy (EIS) was performed for the esophageal varices; however, the patient returned with massive hematemesis from gastric varices 6 months after treatment. Although the varices were treated with EIS, gastric devascularization and splenectomy concomitant with shunt surgery were required to treat uncontrollable, frequent diarrhea and abdominal distension. Because the splenic vein, left gastric vein, left portal vein, and inferior vena cava were inadequate for anastomosis, an epiploic gonadal vein bypass was performed. The bypass graft remains patent 7 months after surgery, and the patient is in good health without any clinical symptoms. We describe a new bypass route for extrahepatic portal venous obstruction.
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan. tasu050520@yahoo.co.jp.
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.affiliation: Department of Gastroenterology, Kochi Health Sciences Center, Kochi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Negoro
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Kozuki
authors.affiliation: Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Iwata
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Saisaka
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Tokumaru
authors.affiliation: Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi City, Kochi, 781-8555, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Radiology, Kochi Health Sciences Center, Kochi, Japan.
authors.forename: Sojiro
authors.initials: S
authors.lastname: Morita
keywords: Epiploic vein; Extrahepatic portal venous obstruction; Gonadal vein; Shunt surgery