Wu Shaojie, Wu Yicheng, Shen Yanfu, Cai Senlin, Zhou Yanfeng, Zheng Haotian, Fang Zhuting
Department of Interventional Radiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, No. 134, Dongjie Road, Fuzhou, 350001, China.
Department of Geriatrics, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Shengli Clinical Medical College of Fujian Medical University, No. 134, Dongjie Road, Fuzhou, 350001, China.
J Interv Med. 2019 Oct 23;2(4):181-183. doi: 10.1016/j.jimed.2019.10.005. eCollection 2019 Nov.
A 64-year-old man was admitted to our hospital with hematemesis and melena. Six years ago, he had undergone total gastrectomy with Roux-en-Y esophagojejunostomy for gastric cancer. Endoscopic examination revealed varicose veins at the anastomotic sites with cherry-red spots and hemorrhage. Abdominal computed tomography showed that the varices were supplied by a dilated jejunal vein. Transjugular intrahepatic portosystemic shunt (TIPS) and variceal embolization were performed. There were no major complications or episodes of bleeding during the three-month follow-up. We conclude that TIPS in combination with varices obliteration is an effective alternative method for treatment of ruptured esophagojejunal varices after total gastrectomy.
一名64岁男性因呕血和黑便入院。六年前，他因胃癌接受了全胃切除术并进行了Roux-en-Y食管空肠吻合术。内镜检查发现吻合部位有静脉曲张，伴有樱桃红点和出血。腹部计算机断层扫描显示，静脉曲张由扩张的空肠静脉供血。进行了经颈静脉肝内门体分流术（TIPS）和曲张静脉栓塞术。在三个月的随访期间，没有出现重大并发症或出血事件。我们得出结论，TIPS联合曲张静脉闭塞术是治疗全胃切除术后食管空肠曲张静脉破裂的一种有效替代方法。
