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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