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经皮经肝途径使用弹簧圈栓塞治疗造口周围静脉曲张出血。

Peristomal variceal bleeding treated by coil embolization using a percutaneous transhepatic approach.

作者信息

Maciel Macello José Sampaio, Pereira Osvaldo Ignácio, Motta Leal Filho Joaquim Maurício, Ziemiecki Junior Enio, Cosme Susyanne Lavor, Souza Moisés Amâncio, Carnevale Francisco Cesar

机构信息

Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.

出版信息

World J Clin Cases. 2016 Jan 16;4(1):25-9. doi: 10.12998/wjcc.v4.i1.25.

Abstract

Peristomal variceal bleeding due to portal hypertension is an entity that has rarely been reported with 3%-4% risk of death. A 68-year-old woman who had undergone a palliative colostomy (colorectal carcinoma) presented with a massive hemorrhage from the colostomy conduit. Considering her oncological status with medial and right hepatic veins thrombosis due to liver metastasis invasion, an emergency transhepatic coil embolization was successfully performed. Standard treatment modality for these cases has not been established. Percutaneous transhepatic coil embolization of varices is a safe and effective choice in patients who present with life threatening bleeding and exhibit contraindications to transjugular intrahepatic portosystemic shunt.

摘要

门静脉高压导致的造口周围静脉曲张出血是一种鲜有报道的病症,其死亡风险为3%-4%。一名68岁因姑息性结肠造口术(结肠直肠癌)就诊的女性患者,其结肠造口管出现大量出血。鉴于其因肝转移侵犯导致肝中静脉和右肝静脉血栓形成的肿瘤状况,成功实施了紧急经肝线圈栓塞术。这些病例的标准治疗方式尚未确立。对于出现危及生命的出血且存在经颈静脉肝内门体分流术禁忌症的患者,经皮经肝静脉曲张线圈栓塞术是一种安全有效的选择。

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