Miyamura Shuto, Ishimaru Hideki, Oka Taiga, Otsuka Tetsuhiro, Yoshimi Satomi, Hidaka Masaaki, Miyazoe Yuri, Uetani Masataka
Department of Radiology, Nagasaki University Hospital, Japan.
Department of Surgery, Nagasaki University Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2022 Jun 3;7(2):63-68. doi: 10.22575/interventionalradiology.2021-0022. eCollection 2022 Jul 1.
We report two cases of chronic portal vein occlusion with jejunal varices successfully treated using percutaneous intervention with a combined transhepatic and transsplenic approach. Case 1 was a 60-year-old man with uncontrolled jejunal variceal bleeding, and case 2 was a 79-year-old man with anastomotic jejunal variceal bleeding and cholangitis. Single access via the transhepatic or transsplenic route failed to allow catheter advancement through the occlusion. After introducing pull-through access via the transhepatic and transsplenic routes, a metallic stent was could be used to dilate the occluded portal vein. Anastomotic jejunal varices functioning as hepatopetal collaterals were embolized after the establishment of antegrade portal flow. No symptom relapse was observed during the follow-up period (31 months for case 1 and 34 months for case 2).
我们报告了两例慢性门静脉闭塞伴空肠静脉曲张患者，采用经肝和经脾联合的经皮介入方法成功治疗。病例1是一名60岁男性，空肠静脉曲张出血无法控制；病例2是一名79岁男性，吻合口空肠静脉曲张出血并伴有胆管炎。经肝或经脾单一路径穿刺未能使导管通过闭塞段。在经肝和经脾路径引入贯通穿刺后，使用金属支架扩张闭塞的门静脉。在建立门静脉顺行血流后，对作为向肝侧支循环的吻合口空肠静脉曲张进行了栓塞。随访期间（病例1为31个月，病例2为34个月）未观察到症状复发。
