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部分脾栓塞术成功控制胃食管静脉曲张出血

Gastroesophageal Variceal Bleeding Successfully Controlled by Partial Splenic Embolization.

作者信息

Kogure Takayuki, Inoue Jun, Kakazu Eiji, Ninomiya Masashi, Shimosegawa Tooru

机构信息

Division of Gastroenterology1, Tohoku University Hospital, Japan.

出版信息

Intern Med. 2017;56(11):1339-1343. doi: 10.2169/internalmedicine.56.8167. Epub 2017 Jun 1.

DOI:10.2169/internalmedicine.56.8167
PMID:28566595
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5498196/
Abstract

A 53-year-old male patient with a history of hepatocellular carcinoma developed gastroesophageal varices refractory to endoscopic injection sclerotherapy (EIS). He required EIS six times in 2 years for recurring variceal bleeding. After hepatic resection, he developed massive splenomegaly. Partial splenic embolization (PSE) was performed to reduce the portal pressure. Varices and variceal bleeding were not detected during 13-year follow up, until the patient died of hepatocellular carcinoma. This is a unique case of gastroesophageal varices controlled by PSE and improved portal hypertension.

摘要

一名有肝细胞癌病史的53岁男性患者出现了对内镜注射硬化疗法（EIS）难治的胃食管静脉曲张。他在2年内因复发性静脉曲张出血接受了6次EIS治疗。肝切除术后，他出现了巨脾。进行了部分脾栓塞术（PSE）以降低门静脉压力。在13年的随访期间未检测到静脉曲张和静脉曲张出血，直到患者死于肝细胞癌。这是一例通过PSE控制胃食管静脉曲张并改善门静脉高压的独特病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/65189f872f89/1349-7235-56-1339-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/8942f6a0e52d/1349-7235-56-1339-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/3d801c597691/1349-7235-56-1339-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/79f3bb7d1619/1349-7235-56-1339-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/d27d7741482c/1349-7235-56-1339-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/65189f872f89/1349-7235-56-1339-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/8942f6a0e52d/1349-7235-56-1339-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/3d801c597691/1349-7235-56-1339-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/79f3bb7d1619/1349-7235-56-1339-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/d27d7741482c/1349-7235-56-1339-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbf/5498196/65189f872f89/1349-7235-56-1339-g005.jpg

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2
Incidence and predictors of rebleeding after band ligation of oesophageal varices.食管静脉曲张套扎术后再出血的发生率及预测因素
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Transjugular Intrahepatic Portosystemic Shunt before and after Liver Transplantation.肝移植前后的经颈静脉肝内门体分流术
Semin Intervent Radiol. 2014 Sep;31(3):243-7. doi: 10.1055/s-0034-1382791.
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Partial splenic artery embolization in cirrhotic patients.肝硬化患者的部分脾动脉栓塞术
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Outcomes after transjugular intrahepatic portosystemic stent shunt: a "bridge" to nowhere.经颈静脉肝内门体分流术的转归：一座“没有尽头的桥”。
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Splenomegaly as risk factor of liver cirrhosis. A retrospective cohort study of 2,525 patients who underwent laparoscopy.脾肿大是肝硬化的危险因素。一项对 2525 例行腹腔镜检查患者的回顾性队列研究。
In Vivo. 2011 Nov-Dec;25(6):1009-12.
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Management of varices and variceal hemorrhage in cirrhosis.肝硬化中静脉曲张及静脉曲张出血的管理
N Engl J Med. 2010 Mar 4;362(9):823-32. doi: 10.1056/NEJMra0901512.
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General rules for recording endoscopic findings of esophagogastric varices (2nd edition).食管胃静脉曲张内镜下所见记录总则（第 2 版）。
Dig Endosc. 2010 Jan;22(1):1-9. doi: 10.1111/j.1443-1661.2009.00929.x.
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