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脊髓血肿作为胃静脉曲张球囊闭塞逆行静脉栓塞术的罕见并发症:一例报告

Spinal Hematoma as a Rare Complication of Balloon-occluded Retrograde Transvenous Obliteration for Gastric Varices: A Case Report.

作者信息

Hagiwara Hiroaki, Takeuchi Yuka, Komita Midori, Yasuda Naofumi, Higa Airi, Kondo Masaaki

机构信息

Department of Radiology, Yokohama Minami Kyosai Hospital, Japan.

Department of Gastroenterology, Yokohama Minami Kyosai Hospital, Japan.

出版信息

Interv Radiol (Higashimatsuyama). 2024 Aug 7;10:e20240006. doi: 10.22575/interventionalradiology.2024-0006. eCollection 2025 Mar 28.

Abstract

We report a case of lumbar spinal hematoma caused by balloon-occluded retrograde transvenous obliteration for gastric varices in a woman in her 60 s with liver cirrhosis due to non-alcoholic steatohepatitis. The patient presented to the emergency department with a chief complaint of sudden nausea and hematemesis. Endoscopic sclerotherapy was performed, followed by balloon-occluded retrograde transvenous obliteration for residual varices. During balloon-occluded retrograde transvenous obliteration, she complained of back pain and subsequently developed thigh pain. CT and MR scans revealed subdural hematoma and subarachnoid hemorrhage within the spinal canal at the thoracolumbar level. It is presumed that balloon-occluded retrograde transvenous obliteration altered blood flow in the paravertebral plexus, causing an intraspinal canal hemorrhage. To our knowledge, this study is the first to report a case of an iatrogenic spinal hematoma caused by balloon-occluded retrograde transvenous obliteration.

摘要

我们报告了一例60多岁因非酒精性脂肪性肝炎导致肝硬化的女性患者,在进行球囊闭塞逆行静脉栓塞治疗胃静脉曲张时发生腰椎血肿的病例。患者因突发恶心和呕血为主诉就诊于急诊科。先行内镜硬化治疗,随后对残留静脉曲张进行球囊闭塞逆行静脉栓塞。在球囊闭塞逆行静脉栓塞过程中,患者诉背痛,随后出现大腿疼痛。CT和磁共振成像扫描显示胸腰段椎管内硬膜下血肿和蛛网膜下腔出血。据推测,球囊闭塞逆行静脉栓塞改变了椎旁静脉丛的血流,导致椎管内出血。据我们所知,本研究首次报告了一例因球囊闭塞逆行静脉栓塞导致的医源性脊髓血肿病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99b8/12078019/60997bd42d5e/2432-0935-10-e2024-0006-g001.jpg

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