Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2023 Dec 25;82(6):295-299. doi: 10.4166/kjg.2023.105.
Duodenal varices are uncommon complications of portal hypertension. Although duodenal variceal bleeding is infrequent, it is a life-threatening condition with a high mortality rate. Non-surgical methods for duodenal variceal bleeding include endoscopic band ligation, endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and retrograde transvenous obliteration. On the other hand, an optimal treatment strategy for this rare condition has not been established. A 38-year-old male with a history of alcoholic liver cirrhosis presented with hematemesis. An emergency esophagogastroduodenoscopy (EGD) revealed large, multiple varices in the second portion of the duodenum, and plug-assisted retrograde transvenous obliteration (PARTO) was performed accordingly. Gastrointestinal bleeding was resolved after the procedure. Follow-up EGD conducted after 11 weeks revealed complete obliteration of the previously observed duodenal varices. PARTO may be considered a viable option for treating duodenal variceal bleeding.
十二指肠静脉曲张是门静脉高压症的罕见并发症。尽管十二指肠静脉曲张出血并不常见，但它是一种危及生命的病症，死亡率很高。十二指肠静脉曲张出血的非手术治疗方法包括内镜套扎、内镜硬化治疗、经颈静脉肝内门体分流术和逆行经静脉闭塞。另一方面，对于这种罕见疾病，尚未建立最佳的治疗策略。一名 38 岁男性，有酒精性肝硬化病史，出现呕血。紧急食管胃十二指肠镜检查（EGD）显示十二指肠第二段有大而多的静脉曲张，并相应进行了栓塞辅助逆行经静脉闭塞（PARTO）。手术后胃肠道出血得到解决。11 周后进行的后续 EGD 显示先前观察到的十二指肠静脉曲张完全闭塞。PARTO 可能是治疗十二指肠静脉曲张出血的一种可行选择。
