TY - JOUR
T1 - Jejunal loop varices resulting from extrahepatic portal obstruction after pancreatoduodenectomy treated with embolization via a transmesenteric approach
AU - Ohyama, Makoto
AU - Kayashima, Hiroto
AU - Harada, Noboru
AU - Maeda, Takashi
AU - Imai, Daisuke
AU - Masuda, Takanobu
AU - Yamaguchi, Shohei
AU - Matsuyama, Ayumi
AU - Tsutsui, Shinichi
AU - Tani, Chihiro
AU - Kakizawa, Hideaki
AU - Matsuda, Hiroyuki
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Bleeding from jejunal loop varices caused by portal vein (PV) stenosis is one of the most critical and refractory late complications following pancreatoduodenectomy (PD). An 82-year-old man who underwent PD 14 years previously for carcinoma of the papilla of Vater with a recurrence in the superior mesenteric lymph nodes with PV stenosis and jejunal loop varisces, was admitted to the emergency room with massive melena. Preoperative 3D-CT could identified both the obvious inflow to the jejunal loop varices through a mesenteric vein and the collateral vessel to the PV through the left gastric vein. Surgical transmesenteric embolization of the jejunal loop varices via a radiologic interventional technique could be performed as planned through the mesenteric vein following preoperative 3D-CT. Postoperative CT showed clear deposition of embolic materials in the varices and stable patency of PV. Bleeding did not recur after the procedure. Based on the simulation using 3D-CT, surgical mesenteric embolization of jejunal loop varices could be performed safely and is one of the most useful therapeutic options for bleeding from the varices.
AB - Bleeding from jejunal loop varices caused by portal vein (PV) stenosis is one of the most critical and refractory late complications following pancreatoduodenectomy (PD). An 82-year-old man who underwent PD 14 years previously for carcinoma of the papilla of Vater with a recurrence in the superior mesenteric lymph nodes with PV stenosis and jejunal loop varisces, was admitted to the emergency room with massive melena. Preoperative 3D-CT could identified both the obvious inflow to the jejunal loop varices through a mesenteric vein and the collateral vessel to the PV through the left gastric vein. Surgical transmesenteric embolization of the jejunal loop varices via a radiologic interventional technique could be performed as planned through the mesenteric vein following preoperative 3D-CT. Postoperative CT showed clear deposition of embolic materials in the varices and stable patency of PV. Bleeding did not recur after the procedure. Based on the simulation using 3D-CT, surgical mesenteric embolization of jejunal loop varices could be performed safely and is one of the most useful therapeutic options for bleeding from the varices.
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U2 - 10.5833/jjgs.2016.0062
DO - 10.5833/jjgs.2016.0062
M3 - Article
AN - SCOPUS:85016089738
VL - 50
SP - 231
EP - 238
JO - Japanese Journal of Gastroenterological Surgery
JF - Japanese Journal of Gastroenterological Surgery
SN - 0386-9768
IS - 3
ER -