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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