Successful Management of Duodenal Varices by Balloon-occluded Retrograde Transvenous Obliteration

Masahiro Hotta; Hiroshi Yoshida; Yasuhiro Mamada; Nobuhiko Taniai; Koichi Bando; Yoshiaki Mizuguchi; Daisuke Kakinuma; Tomohiro Kanda; Ken-ichiro Watanabe; Takashi Tajiri

doi:10.1272/jnms.75.36

Case Reports

Successful Management of Duodenal Varices by Balloon-occluded Retrograde Transvenous Obliteration

Masahiro Hotta, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Koichi Bando, Yoshiaki Mizuguchi, Daisuke Kakinuma, Tomohiro Kanda, Ken-ichiro Watanabe, Takashi Tajiri

Author information

Masahiro Hotta
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Hiroshi Yoshida
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Yasuhiro Mamada
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Nobuhiko Taniai
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Koichi Bando
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Yoshiaki Mizuguchi
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Daisuke Kakinuma
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Tomohiro Kanda
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Ken-ichiro Watanabe
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
Takashi Tajiri
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School

Keywords: balloon-occluded retrograde transvenous obliteration, duodenal varices, portal hypertension

JOURNAL FREE ACCESS

2008 Volume 75 Issue 1 Pages 36-40

DOI https://doi.org/10.1272/jnms.75.36

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Abstract

We describe a case of duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration (BRTO) alone. A 63-year-old man presented with tarry stools. Computed tomography demonstrated dilated varices around the duodenum. Emergency endoscopic examination revealed varices of the second portion of the duodenum without active bleeding. There was no evidence of bleeding in the esophagus or stomach. Colonoscopy revealed no bleeding sites in the colon. On the day after admission, a superior mesenteric arteriogram obtained in the venous phase demonstrated a collateral vein from the inferior pancreaticoduodenal vein to the inferior vena cava. Retrograde venography performed via the right femoral vein confirmed that the right inferior adrenal vein was the draining vein and that the collateral vein was occluded. There were no tarry stools after BRTO. The patient was discharged 7 days after BRTO. Two months after discharge, computed tomography showed no dilated varices around the duodenum. Three months after discharge, endoscopy confirmed the absence of varices. No bleeding has been detected as of 10 months after discharge. We conclude that BRTO is an effective treatment for duodenal varices.

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