The efficacy of balloon-occluded retrograde transvenous obliteration on small intestinal variceal bleeding

Naotaka Hashimoto, Tomohiko Akahoshi, Daisuke Yoshida, Nao Kinjo, Kozo Konishi, Hideo Uehara, Yoshihiro Nagao, Hirofumi Kawanaka, Morimasa Tomikawa, Yoshihiko Maehara

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Small intestinal variceal bleeding is an unusual cause of gastrointestinal hemorrhaging of portal hypertensive patients, but once it occurs it may lead to life-threatening bleeding because this problem is difficult to diagnose and treat. This study investigated the efficacy of balloon occluded retrograde transvenous obliteration (B-RTO) to treat small intestinal variceal bleeding. Methods: From 2003 to 2007, 6 patients with small variceal bleeding were treated by B-RTO. The characteristics of the patients, B-RTO procedures, prognosis, and occurrence of risky esophageal and gastric varices were evaluated according to their medical records. Results: Three-dimensional (3-D) angiography by MD-CT was useful for the diagnosis of small intestinal varices and the draining vessels. In all cases, variceal bleeding was controlled by B-RTO treatment, although rebleeding was recognized in one patient after 30 months (16.6%). All patients were alive throughout the follow-up except 1 patient who died of liver failure (6-44 months). Risky esophageal varices and gastric varices occurred in 2 patients (33.3%) after B-RTO. However, no variceal bleeding occurred. Conclusion: B-RTO was found to be an effective treatment modality which provided good initial hemostasis, thereby eradicating ectopic small intestinal varices.

Original languageEnglish
Pages (from-to)145-150
Number of pages6
JournalSurgery
Volume148
Issue number1
DOIs
Publication statusPublished - Jul 1 2010

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Hemorrhage
Esophageal and Gastric Varices
Varicose Veins
Liver Failure
Hemostasis
Medical Records
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

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The efficacy of balloon-occluded retrograde transvenous obliteration on small intestinal variceal bleeding. / Hashimoto, Naotaka; Akahoshi, Tomohiko; Yoshida, Daisuke; Kinjo, Nao; Konishi, Kozo; Uehara, Hideo; Nagao, Yoshihiro; Kawanaka, Hirofumi; Tomikawa, Morimasa; Maehara, Yoshihiko.

In: Surgery, Vol. 148, No. 1, 01.07.2010, p. 145-150.

Research output: Contribution to journalArticle

Hashimoto, N, Akahoshi, T, Yoshida, D, Kinjo, N, Konishi, K, Uehara, H, Nagao, Y, Kawanaka, H, Tomikawa, M & Maehara, Y 2010, 'The efficacy of balloon-occluded retrograde transvenous obliteration on small intestinal variceal bleeding', Surgery, vol. 148, no. 1, pp. 145-150. https://doi.org/10.1016/j.surg.2009.10.052
Hashimoto, Naotaka ; Akahoshi, Tomohiko ; Yoshida, Daisuke ; Kinjo, Nao ; Konishi, Kozo ; Uehara, Hideo ; Nagao, Yoshihiro ; Kawanaka, Hirofumi ; Tomikawa, Morimasa ; Maehara, Yoshihiko. / The efficacy of balloon-occluded retrograde transvenous obliteration on small intestinal variceal bleeding. In: Surgery. 2010 ; Vol. 148, No. 1. pp. 145-150.
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