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Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices
We report a case of life-threatening bleeding from gastric varices in a patient with alcoholic cirrhosis, which was treated by emergency transileocolic vein obliteration (TIO). A 46-year-old male with a massive hematemesis was transported to our hospital by ambulance. Contrast-enhanced computed tomo...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9941876/ https://www.ncbi.nlm.nih.gov/pubmed/36824993 http://dx.doi.org/10.1016/j.radcr.2023.01.045 |
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author | Chikamori, Fumio Mizobuchi, Kai Hamada, Ryo Ito, Satoshi Uemura, Sunao Yamada, Ryo Matsuoka, Hisashi Tanida, Nobuyuki Sharma, Niranjan |
author_facet | Chikamori, Fumio Mizobuchi, Kai Hamada, Ryo Ito, Satoshi Uemura, Sunao Yamada, Ryo Matsuoka, Hisashi Tanida, Nobuyuki Sharma, Niranjan |
author_sort | Chikamori, Fumio |
collection | PubMed |
description | We report a case of life-threatening bleeding from gastric varices in a patient with alcoholic cirrhosis, which was treated by emergency transileocolic vein obliteration (TIO). A 46-year-old male with a massive hematemesis was transported to our hospital by ambulance. Contrast-enhanced computed tomography demonstrated large gastric varices. Temporary hemostasis using balloon tamponade was attempted, however, bleeding could not be controlled, and his vital signs were unstable despite massive blood transfusions. First, endoscopic treatment was attempted, but the visual field could not be secured due to massive bleeding. Therefore, emergency TIO under general anesthesia was attempted. After laparotomy, 5 Fr. sheath was inserted into the ileocolic vein. Posterior and left gastric veins, which were the blood supply routes of gastric varices, were identified and embolized using microcoils and a 50% glucose solution. Hemostasis was achieved and vital signs recovered. Three days after TIO, transjugular retrograde obliteration was attempted successfully to embolize the residual gastric varices. After the procedures, his condition improved. We conclude that emergency TIO is a useful rescue option for life-threatening bleeding from gastric varices if endoscopic treatment or balloon tamponade is ineffective. |
format | Online Article Text |
id | pubmed-9941876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-99418762023-02-22 Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices Chikamori, Fumio Mizobuchi, Kai Hamada, Ryo Ito, Satoshi Uemura, Sunao Yamada, Ryo Matsuoka, Hisashi Tanida, Nobuyuki Sharma, Niranjan Radiol Case Rep Case Report We report a case of life-threatening bleeding from gastric varices in a patient with alcoholic cirrhosis, which was treated by emergency transileocolic vein obliteration (TIO). A 46-year-old male with a massive hematemesis was transported to our hospital by ambulance. Contrast-enhanced computed tomography demonstrated large gastric varices. Temporary hemostasis using balloon tamponade was attempted, however, bleeding could not be controlled, and his vital signs were unstable despite massive blood transfusions. First, endoscopic treatment was attempted, but the visual field could not be secured due to massive bleeding. Therefore, emergency TIO under general anesthesia was attempted. After laparotomy, 5 Fr. sheath was inserted into the ileocolic vein. Posterior and left gastric veins, which were the blood supply routes of gastric varices, were identified and embolized using microcoils and a 50% glucose solution. Hemostasis was achieved and vital signs recovered. Three days after TIO, transjugular retrograde obliteration was attempted successfully to embolize the residual gastric varices. After the procedures, his condition improved. We conclude that emergency TIO is a useful rescue option for life-threatening bleeding from gastric varices if endoscopic treatment or balloon tamponade is ineffective. Elsevier 2023-02-10 /pmc/articles/PMC9941876/ /pubmed/36824993 http://dx.doi.org/10.1016/j.radcr.2023.01.045 Text en © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Chikamori, Fumio Mizobuchi, Kai Hamada, Ryo Ito, Satoshi Uemura, Sunao Yamada, Ryo Matsuoka, Hisashi Tanida, Nobuyuki Sharma, Niranjan Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
title | Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
title_full | Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
title_fullStr | Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
title_full_unstemmed | Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
title_short | Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
title_sort | emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9941876/ https://www.ncbi.nlm.nih.gov/pubmed/36824993 http://dx.doi.org/10.1016/j.radcr.2023.01.045 |
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