经颈静脉肝内途径行球囊闭塞顺行性经静脉闭塞术治疗直肠静脉曲张出血

Balloon-occluded antegrade transvenous obliteration via transjugular intrahepatic access for bleeding rectal varices.

作者信息

Shin David S, Kim Andrew G, Ingraham Christopher R

机构信息

Department of Radiology, University of Washington, Seattle, Washington, U.S.A. 1959 NE Pacific St, Box 357115, Seattle, WA 98195, USA.

出版信息

Radiol Case Rep. 2019 Apr 15;14(7):805-808. doi: 10.1016/j.radcr.2019.04.001. eCollection 2019 Jul.

DOI:10.1016/j.radcr.2019.04.001

PMID:31015887

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6468156/

Abstract

Bleeding rectal varices in cirrhotic patients with portal hypertension can be difficult to treat endoscopically or surgically. Transjugular intrahepatic portosystemic shunt creation offers a minimally invasive method to effectively decompress the portal system but may be contraindicated in patients with poor hepatic reserve or hepatic encephalopathy. We present a case of a 44-year-old woman with persistent rectal variceal bleeding, who was a poor candidate for endoscopic intervention, surgery, or transjugular intrahepatic portosystemic shunt. We therefore performed balloon-occluded antegrade transvenous obliteration of the rectal varices via transjugular intrahepatic access, which effectively controlled her rectal bleeding.

摘要

门静脉高压肝硬化患者的直肠静脉曲张出血在内镜或手术治疗上可能具有挑战性。经颈静脉肝内门体分流术是一种微创方法，可有效降低门静脉系统压力，但对于肝储备功能差或有肝性脑病的患者可能为禁忌。我们报告一例44岁女性，患有持续性直肠静脉曲张出血，不适合接受内镜干预、手术或经颈静脉肝内门体分流术。因此，我们通过经颈静脉肝内途径对直肠静脉曲张进行球囊闭塞顺行静脉栓塞术，有效控制了她的直肠出血。