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经颈静脉途径通过脾肾分流术进行顺行性经静脉硬化疗法成功治疗直肠静脉曲张。

Successful treatment of rectal varices with antegrade transvenous sclerotherapy via the splenorenal shunt from the transjugular approach.

作者信息

Pas Maciej, Jogo Atsushi, Yamamoto Akira, Nishida Norifumi, Jogo Eri, Kageyama Ken, Sohgawa Etsuji, Miki Yukio

机构信息

Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.

Department of Radiology, Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ward, Osaka City, Osaka, 530-0012, Japan.

出版信息

Radiol Case Rep. 2022 Sep 30;17(12):4679-4684. doi: 10.1016/j.radcr.2022.08.096. eCollection 2022 Dec.

DOI:10.1016/j.radcr.2022.08.096
PMID:36204409
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9530408/
Abstract

A 74-year-old patient presented with hematochezia and a history of liver cirrhosis with repeated bleeding from esophageal and rectal varices. Endoscopic examination revealed multiple rectal varices with positive red color signs. Ascites, severe portosystemic thrombosis and a splenorenal shunt were diagnosed on a contrast-enhanced dynamic computed tomography examination. From a transjugular approach, we circumvented thrombosed regions by maneuvering double balloon catheters through the shunt and dilated left colic marginal vein. We managed to successfully obliterate the varices.

摘要

一名74岁患者出现便血，有肝硬化病史，曾反复出现食管和直肠静脉曲张出血。内镜检查发现多处直肠静脉曲张，红色征阳性。在增强动态计算机断层扫描检查中诊断出腹水、严重的门体系统血栓形成和脾肾分流。我们采用经颈静脉途径，通过分流处操纵双气囊导管避开血栓形成区域，并扩张左结肠边缘静脉。我们成功地消除了静脉曲张。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/a87d0082a2ec/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/fc7a933414f8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/1194a969ecb8/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/77d967878651/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/82bad2daf653/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/a87d0082a2ec/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/fc7a933414f8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/1194a969ecb8/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/77d967878651/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/82bad2daf653/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70f/9530408/a87d0082a2ec/gr5.jpg

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本文引用的文献

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ANZ J Surg. 2021 Jan;91(1-2):49-54. doi: 10.1111/ans.15982. Epub 2020 May 14.
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Treating Untreatable Rectal Varices.治疗无法治疗的直肠静脉曲张。
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Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy.门静脉高压症：门体静脉分流途径的影像学检查及相关影像引导治疗
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Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices.经颈静脉肝内门体分流术治疗直肠静脉曲张出血的潜在陷阱。
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Cardiovasc Intervent Radiol. 2015 Oct;38(5):1320-4. doi: 10.1007/s00270-015-1174-4. Epub 2015 Jul 11.
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Collateral pathways in portal hypertension.门静脉高压症中的侧支循环途径。
J Clin Exp Hepatol. 2012 Dec;2(4):338-52. doi: 10.1016/j.jceh.2012.08.001. Epub 2012 Dec 16.
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