Argirò Renato, Vattermoli Leonardo, Di Pietro Francesca, Crociati Sara, Funari Luca, Perlangeli Valentina, Floris Roberto
Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, Rome, 00133, Italy.
Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy.
Radiol Case Rep. 2022 Feb 12;17(4):1271-1275. doi: 10.1016/j.radcr.2022.01.031. eCollection 2022 Apr.
Jejunal varices are a rare cause of gastrointestinal bleeding. In most cases, they are due to portal hypertension related to liver cirrhosis, less frequently to superior mesenteric vein stenosis (SMV). In this article we describe an unusual case of a 61 year-old male patient who arrived at our emergency department with intermittent variceal bleeding due to jejunal varices causing melena and subsequent chronic anaemia. Patient was indeed discovered to have primary idiopathic superior mesenteric vein stenosis. We managed to treat this patient via SMV stenting through percutaneous transhepatic approach. In cases of upper-GI bleed with negative endoscopy for active bleeding, a contrast-enhanced CT scan should be performed to diagnose jejunal varices and their underlying cause, such as SMV stenosis which is best treated with percutaneous phlebography.
空肠静脉曲张是胃肠道出血的罕见原因。在大多数情况下，它们是由与肝硬化相关的门静脉高压引起的，较少见的原因是肠系膜上静脉狭窄（SMV）。在本文中，我们描述了一例不寻常的病例，一名61岁男性患者因空肠静脉曲张导致黑便和随后的慢性贫血，间歇性静脉曲张出血后到我们急诊科就诊。该患者确实被发现患有原发性特发性肠系膜上静脉狭窄。我们通过经皮经肝途径进行SMV支架置入术成功治疗了该患者。对于上消化道出血且内镜检查未发现活动性出血的病例，应进行增强CT扫描以诊断空肠静脉曲张及其潜在病因，如SMV狭窄，其最佳治疗方法是经皮静脉造影。
