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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.

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/fc7a933414f8/gr1.jpg

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