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KMID : 0614620200760060331
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Korean Journal of Gastroenterology
2020 Volume.76 No. 6 p.331 ~ p.336
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Percutaneous Trans-splenic Obliteration for Duodenal Variceal bleeding: A Case Report
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Kim Hyun-Woo
Yoon Jun-Sik
Yu Seung-Jung
Kim Tae-Heon
Seol Jae-Heon
Kim Dan
Jung Jun-Young
Jeong Pyeong-Hwa
Kwon Hoon
Lee Hong-Sub
Lee Sang-Heon
Choi Jung-Sik
Park Sung-Jae
Jee Sam-Ryong
Lee Youn-Jae
Seol Sang-Yong
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Abstract
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Duodenal varices are a serious complication of portal hypertension. Bleeding from duodenal varices is rare, but when bleeding does occur, it is massive and can be fatal. Unfortunately, the optimal therapeutic modality for duodenal variceal bleeding is unclear. This paper presents a patient with duodenal variceal bleeding that was managed successfully using percutaneous trans-splenic variceal obliteration (PTVO). A 56-year-old man with a history of alcoholic cirrhosis presented with a 6-day history of melena. Emergency esophagogastroduodenoscopy revealed a large, bluish mass with a nipple sign in the second portion of the duodenum. Coil embolization of the duodenal varix was performed via a trans-splenic approach (i.e., PTVO). The patient no longer complained of melena after treatment. The duodenal varix was no longer visible at the follow-up esophagogastroduodenoscopy performed three months after PTVO. The use of PTVO might be a viable option for the treatment of duodenal variceal bleeding.
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KEYWORD
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Duodenum, Varicose veins, Gastrointestinal hemorrhage, Embolization, therapeutic
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