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KMID : 1038120200530060750
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Clinical Endoscopy
2020 Volume.53 No. 6 p.750 ~ p.753
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Endoscopic Ultrasound-Guided Vascular Therapy for Portoduodenal Fistula
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Chantarojanasiri Tanyaporn
Sirinawasatien Apichet
Bunchorntavakul Chalermrat
Siripun Aroon
Treepongkaruna Sa-ard
Ratanachu-ek Thawee
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Abstract
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Portoenteric fistula is a rare cause of massive upper gastrointestinal bleeding. Most cases can be treated with radiointervention or surgery, but portoenteric fistula is associated with a high mortality. We reported a case of intermittent massive upper gastrointestinal bleeding in a 33-year-old man with cholangiocarcinoma who underwent surgical resection followed by chemoradiation. A portoduodenal fistula due to chronic duodenal ulceration was identified. The bleeding was successfully controlled by endoscopic ultrasound-guided coil placement through the duodenal bulb using the anchoring technique. Follow-up endoscopy and computed tomography scan showed multiple coil placements between a part of the portal vein and the duodenal bulb without any evidence of portal vein thrombosis. There were no complications, and bleeding did not recur during the 8-month follow-up period.
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KEYWORD
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Endosonography, Gastrointestinal hemorrhage, Vascular fistula
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