治疗无法治疗的直肠静脉曲张。
Treating Untreatable Rectal Varices.
作者信息
Garrido Mónica, Gonçalves Belarmino, Ferreira Sofia, Rocha Marta, Salgado Marta, Pedroto Isabel
机构信息
Department of Gastroenterology, Porto University Hospital Centre, Porto, Portugal.
Department of Interventional Radiology, Portuguese Oncology Institute, Porto, Portugal.
出版信息
GE Port J Gastroenterol. 2019 Oct;26(6):420-424. doi: 10.1159/000496121. Epub 2019 Feb 15.
BACKGROUND
Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Despite their significant prevalence among cirrhotic patients, clinically important bleeding occurs only in a minority. Various treatment options are available, with endoscopic therapies being widely used, and both interventional radiology and surgery being considered for refractory bleeding rectal varices.
CASE
We report the case of a 61-year-old male with hepatic cirrhosis and bleedingrectal varices refractory to endoscopic therapy, successfully managed with a combination of transjugular intrahepatic portosystemic shunt (TIPS) and selective variceal embolization.
CONCLUSIONS
Radiological techniques are effective options for refractory bleeding. Adding embolization to TIPS implantation could represent a valid adjunctive measure for haemostasis of recurrent rectal variceal bleeding.
背景
直肠静脉曲张是门静脉高压并发症所形成的门体侧支循环。尽管在肝硬化患者中其发生率颇高，但具有临床意义的出血仅发生于少数患者。现有多种治疗选择，内镜治疗应用广泛，而介入放射学及外科手术则用于治疗难治性出血性直肠静脉曲张。
病例
我们报告一例61岁男性患者，患有肝硬化且内镜治疗难治性出血性直肠静脉曲张，通过经颈静脉肝内门体分流术（TIPS）联合选择性静脉曲张栓塞成功治疗。
结论
放射学技术是治疗难治性出血的有效选择。在TIPS植入基础上加用栓塞术可能是复发性直肠静脉曲张出血止血的有效辅助措施。
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