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Percutaneous Trans-hepatic Obliteration for Bleeding Esophagojejunal Varices After Total Gastrectomy and Esophagojejunostomy

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Abstract

A 72-year-old man who had undergone a total gastrectomy with a Roux-en-Y esophagojejunostomy for gastric cancer 6 years earlier presented to our hospital with massive hematemesis and melena. Endoscopic examination indicated esophageal varices with cherry-red spots and hemorrhage arising from beyond the anastomosis. Abdominal contrast-enhanced computed tomography and angiography revealed a dilated vein in the elevated jejunal limb supplying the varices. Percutaneous trans-hepatic obliteration (PTO) of the varices through the jejunal vein was performed using microcoils, ethanolamine oleate, and gelatin sponge cubes. Ten days after the procedure, endoscopic examination revealed reduction and thrombosis of the varices. We consider PTO to be an effective alternative method for treating ruptured esophagojejunal varices after total gastrectomy.

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Authors and Affiliations

  1. Department of Radiology, Shinko-Kakogawa Steel Hospital, 797-295, Isshiki, Hiraoka-cho, Kakogawa, 675-0115, Japan

    Michiko Boku & Tetsu Nakamura

  2. Department of Surgery, Shinko-Kakogawa Steel Hospital, 797-295, Isshiki, Hiraoka-cho, Kakogawa, 675-0115, Japan

    Yasufumi Kita

  3. Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Koji Sugimoto, Carlos A. Zamora & Kazuro Sugimura

Authors
  1. Michiko Boku
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  2. Koji Sugimoto
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  3. Tetsu Nakamura
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  4. Yasufumi Kita
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  5. Carlos A. Zamora
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  6. Kazuro Sugimura
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Correspondence to Carlos A. Zamora.

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Boku, M., Sugimoto, K., Nakamura, T. et al. Percutaneous Trans-hepatic Obliteration for Bleeding Esophagojejunal Varices After Total Gastrectomy and Esophagojejunostomy. Cardiovasc Intervent Radiol 29, 1152–1155 (2006). https://doi.org/10.1007/s00270-004-0092-7

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  • DOI: https://doi.org/10.1007/s00270-004-0092-7

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