Taniguchi Hideaki, Shibagaki Koutaro, Goto Daisuke, Kakehi Eiichi
Department of Internal Medicine, Tottori Municipal Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2015 Nov;112(11):1998-2004. doi: 10.11405/nisshoshi.112.1998.
An 80-year-old woman with a history of chronic hepatitis B was referred to our hospital because of upper gastrointestinal bleeding of unknown origin. Dynamic computed tomography revealed liver cirrhosis and hepatofugal collateral vessels around the duodenum. Emergency esophagogastroduodenoscopy showed duodenal varices with an erosive spot, highly suggestive of a variceal rupture site. We immediately performed endoscopic clipping of the ruptured site to achieve temporary hemostasis. Ten days later, elective balloon-occluded retrograde transvenous obliteration (B-RTO) was performed to prevent recurrence. We describe a successfully treated case of duodenal variceal rupture managed by combination therapy with endoscopic clipping and B-RTO.
一名有慢性乙型肝炎病史的80岁女性因不明原因的上消化道出血被转诊至我院。动态计算机断层扫描显示肝硬化及十二指肠周围的肝外分流血管。急诊食管胃十二指肠镜检查显示十二指肠静脉曲张并有一处糜烂点，高度提示为静脉曲张破裂部位。我们立即对破裂部位进行内镜夹闭以实现临时止血。十天后，进行了选择性球囊闭塞逆行静脉栓塞术（B-RTO）以预防复发。我们描述了一例通过内镜夹闭和B-RTO联合治疗成功治愈的十二指肠静脉曲张破裂病例。
