Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan.
Department of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.
Cardiovasc Intervent Radiol. 2019 Aug;42(8):1204-1207. doi: 10.1007/s00270-019-02235-4. Epub 2019 May 9.
A 49-year-old man with alcoholic liver cirrhosis was admitted to our hospital with abdominal pain. Contrast-enhanced CT demonstrated massive hemorrhagic ascites and ectopic varices fed by right colic and ileocolic veins. The varices were treated with selective embolization via a recanalized paraumbilical vein using N-butyl cyanoacrylate. Currently, no complications and rebleeding have occurred for 7 months. Antegrade embolization via a recanalized paraumbilical vein is feasible and less-invasive in a patient with massive ascites. Flow reduction may be effective for intraabdominal hemorrhage from ruptured ectopic varices. LEVEL OF EVIDENCE: Level 5, case report.
一位 49 岁的男性,患有酒精性肝硬化,因腹痛入住我院。增强 CT 显示大量血性腹水和由右结肠和回结肠静脉供血的异位静脉曲张。通过重新开通的脐旁静脉使用氰基丙烯酸正丁酯对静脉曲张进行了选择性栓塞治疗。目前,患者已经 7 个月没有出现并发症和再出血。对于大量腹水的患者,经重新开通的脐旁静脉顺行栓塞是可行且微创的。血流减少可能对破裂的异位静脉曲张引起的腹腔内出血有效。证据等级:5 级,病例报告。