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Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report

A 79-year-old woman with a history of advanced gastric cancer and portal vein tumor thrombus, treated with surgery and chemoradiotherapy, presented with hematemesis due to esophageal variceal bleeding around the esophagojejunal anastomosis. Endoscopic treatment was unsuccessful. Due to portal vein o...

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Autores principales: Onishi, Yasuyuki, Shimizu, Hironori, Tsunoda, Shigeru, Obama, Kazutaka, Nakamoto, Yuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259231/
https://www.ncbi.nlm.nih.gov/pubmed/34257786
http://dx.doi.org/10.1016/j.radcr.2021.06.018
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author Onishi, Yasuyuki
Shimizu, Hironori
Tsunoda, Shigeru
Obama, Kazutaka
Nakamoto, Yuji
author_facet Onishi, Yasuyuki
Shimizu, Hironori
Tsunoda, Shigeru
Obama, Kazutaka
Nakamoto, Yuji
author_sort Onishi, Yasuyuki
collection PubMed
description A 79-year-old woman with a history of advanced gastric cancer and portal vein tumor thrombus, treated with surgery and chemoradiotherapy, presented with hematemesis due to esophageal variceal bleeding around the esophagojejunal anastomosis. Endoscopic treatment was unsuccessful. Due to portal vein occlusion, percutaneous transhepatic access was difficult. Thus, the middle colic vein, which was dilated due to portal vein occlusion, was percutaneously punctured, and antegrade embolization of a jejunal vein feeding the varices was performed using a microcatheter through a 4-F dilator placed as a sheath. After embolization, the sheath was removed, and ultrasound-guided compression of the puncture site was performed. No bleeding complication occurred. Therefore, direct percutaneous access to a mesenteric vein is a viable alternative to transhepatic access.
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spelling pubmed-82592312021-07-12 Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report Onishi, Yasuyuki Shimizu, Hironori Tsunoda, Shigeru Obama, Kazutaka Nakamoto, Yuji Radiol Case Rep Case Report A 79-year-old woman with a history of advanced gastric cancer and portal vein tumor thrombus, treated with surgery and chemoradiotherapy, presented with hematemesis due to esophageal variceal bleeding around the esophagojejunal anastomosis. Endoscopic treatment was unsuccessful. Due to portal vein occlusion, percutaneous transhepatic access was difficult. Thus, the middle colic vein, which was dilated due to portal vein occlusion, was percutaneously punctured, and antegrade embolization of a jejunal vein feeding the varices was performed using a microcatheter through a 4-F dilator placed as a sheath. After embolization, the sheath was removed, and ultrasound-guided compression of the puncture site was performed. No bleeding complication occurred. Therefore, direct percutaneous access to a mesenteric vein is a viable alternative to transhepatic access. Elsevier 2021-07-03 /pmc/articles/PMC8259231/ /pubmed/34257786 http://dx.doi.org/10.1016/j.radcr.2021.06.018 Text en © 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Onishi, Yasuyuki
Shimizu, Hironori
Tsunoda, Shigeru
Obama, Kazutaka
Nakamoto, Yuji
Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report
title Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report
title_full Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report
title_fullStr Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report
title_full_unstemmed Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report
title_short Direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: A case report
title_sort direct percutaneous access to a mesenteric vein for antegrade embolization of esophageal varices: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259231/
https://www.ncbi.nlm.nih.gov/pubmed/34257786
http://dx.doi.org/10.1016/j.radcr.2021.06.018
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