Kogure Takayuki, Inoue Jun, Kakazu Eiji, Ninomiya Masashi, Shimosegawa Tooru
Division of Gastroenterology1, Tohoku University Hospital, Japan.
Intern Med. 2017;56(11):1339-1343. doi: 10.2169/internalmedicine.56.8167. Epub 2017 Jun 1.
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.
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。