Costa Daniel da, Montenegro Cristián, Palavecino Patricio, Lobos Germán, Cermenati Tomás, Poniachik Jaime
Escuela de Postgrado, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Sección de Gastroenterología, Hospital Clínico, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2017 Oct;145(10):1336-1341. doi: 10.4067/S0034-98872017001001336.
Management of gastrointestinal bleeding caused by fundal varices is particularly difficult to manage. The options are: transjugular intrahepatic portosystemic shunt (TIPS), endoscopic injection of cyanoacrylate or balloon-occluded retrograde transvenous obliteration (BRTO). We report a 63 year-old male with a cirrhosis caused by hepatitis C and a 66 year-old female with a cirrhosis caused by a non-alcoholic steatohepatitis. Both patients had a gastrointestinal bleeding caused by fundal varices and were treated with sclerotherapy with cyanoacrylate assisted with BRTO. Flow was interrupted in the gastro-renal shunt by a femoral access in both patients. The male patient had a new bleeding two months later and died. In the female patient an endosonography performed nine months after the procedure showed absence of remaining varices.
胃底静脉曲张引起的胃肠道出血的管理尤其困难。治疗选择包括：经颈静脉肝内门体分流术（TIPS）、内镜下注射氰基丙烯酸酯或球囊闭塞逆行静脉栓塞术（BRTO）。我们报告了一名63岁因丙型肝炎导致肝硬化的男性患者和一名66岁因非酒精性脂肪性肝炎导致肝硬化的女性患者。两名患者均因胃底静脉曲张引起胃肠道出血，并接受了氰基丙烯酸酯硬化治疗辅助BRTO。两名患者均通过股动脉通路中断了胃肾分流的血流。男性患者两个月后再次出血并死亡。女性患者术后九个月进行的超声内镜检查显示无残留静脉曲张。
