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KMID : 0985520130180030037
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Korean Journal of Pancreas and Biliary Tract
2013 Volume.18 No. 3 p.37 ~ p.40
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Jejunal Varix Bleeding after Pancreaticoduodenectomy Successfully Treated with Portal Vein Stent Placement and Endoscopic Sclerotherapy
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Na Hyun-Jin
Kang Wom-Sik
Park Kyung-Won
Choi Ja-Sung
Kang Beo-Deul
Cho Jae-Hee
Kim Hyun-Boem
Kim Hee-Man
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Abstract
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A 57-year-old woman, who had undergone pancreaticoduodenectomy and chemo-radiation therapy for common bile duct cancer 7 years ago, visited our institution for hematochezia. Esophagogastroduodenoscopy and colonoscopy couldn’t detect bleeding focus and abdomen computed tomography showed stenosis of portal vein and jejunal varices. Subsequent to percutaneous transhepatic portography, we dilated the extrahepatic portal vein using a balloon catheter and placed a stent. The patient had hematochezia after two weeks again. EGD was performed and a new stigmata was found at the afferent loop of small bowel. We injected histoacryl and no more bleeding was occurred. For the treatment of jejunal varices, a less invasive approach, such as portal stent placement and endoscopic sclerotherapy can be a useful tool, especially after abdominal surgery.
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KEYWORD
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jejunal varices, portal vein stenosis, sclerotherapy, pancreaticoduodenectomy
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