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Modified interventional obliteration for variceal hemorrhage from elevated jejunum after pylorus-preserving pancreatoduodenectomy

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Abstract

Ectopic variceal hemorrhage caused by sinistral portal hypertension after splenic vein ligation during a pyloric-preserving pancreatoduodenectomy is a rare entity. We report the case of a 58-year-old man with symptoms of refractory melena. The varices could not be treated endoscopically and surgery was considered unsuitable due to severe adhesions and altered anatomy. Following clinical failure of partial splenic embolization, an alternative obliteration method by a retrograde trans-portal-venous approach was successfully performed and resolved the problem. It seems to be an effective method for ectopic variceal bleeding, especially when other interventions are unavailable or highly risky.

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Conflict of interest

The authors (eight persons) declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Center for Endovascular Therapy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0057, Japan

    Noriaki Sakamoto, Masato Yamaguchi, Keitaro Sofue, Akhmadu Muradi, Koji Idoguchi, Takuya Okada, Eisuke Ueshima & Koji Sugimoto

Authors
  1. Noriaki Sakamoto
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  2. Masato Yamaguchi
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  3. Keitaro Sofue
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  4. Akhmadu Muradi
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  5. Koji Idoguchi
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  6. Takuya Okada
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  7. Eisuke Ueshima
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  8. Koji Sugimoto
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Corresponding author

Correspondence to Noriaki Sakamoto.

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Sakamoto, N., Yamaguchi, M., Sofue, K. et al. Modified interventional obliteration for variceal hemorrhage from elevated jejunum after pylorus-preserving pancreatoduodenectomy. Jpn J Radiol 32, 487–490 (2014). https://doi.org/10.1007/s11604-014-0318-9

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  • DOI: https://doi.org/10.1007/s11604-014-0318-9

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