Percutaneous Trans-splenic Obliteration for Duodenal Variceal bleeding: A Case Report

Duodenal varices are a serious complication of portal hypertension. Bleeding from duodenal varices is rare, but when bleeding does occur, it is massive and can be fatal. Unfortunately, the optimal therapeutic modality for duodenal variceal bleeding is unclear. This paper presents a patient with duod...

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Bibliographic Details
Published in:	The Korean journal of gastroenterology Vol. 76; no. 6; pp. 331 - 336
Main Authors:	Kim, Hyun Woo, Yoon, Jun Sik, Yu, Seung Jung, Kim, Tae Heon, Seol, Jae Heon, Kim, Dan, Jung, Jun Young, Jeong, Pyeong Hwa, Kwon, Hoon, Lee, Hong Sub, Lee, Sang Heon, Choi, Jung Sik, Park, Sung Jae, Jee, Sam Ryong, Lee, Youn Jae, Seol, Sang Yong
Format:	Journal Article
Language:	English
Published:	Jin Publishing & Printing Co 25-12-2020 대한소화기학회
Subjects:	duodenum embolization gastrointestinal hemorrhage therapeutic varicose veins 내과학
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Summary:	Duodenal varices are a serious complication of portal hypertension. Bleeding from duodenal varices is rare, but when bleeding does occur, it is massive and can be fatal. Unfortunately, the optimal therapeutic modality for duodenal variceal bleeding is unclear. This paper presents a patient with duodenal variceal bleeding that was managed successfully using percutaneous trans-splenic variceal obliteration (PTVO). A 56-year-old man with a history of alcoholic cirrhosis presented with a 6-day history of melena. Emergency esophagogastroduodenoscopy revealed a large, bluish mass with a nipple sign in the second portion of the duodenum. Coil embolization of the duodenal varix was performed via a trans-splenic approach (i.e., PTVO). The patient no longer complained of melena after treatment. The duodenal varix was no longer visible at the follow-up esophagogastroduodenoscopy performed three months after PTVO. The use of PTVO might be a viable option for the treatment of duodenal variceal bleeding.
ISSN:	1598-9992 2233-6869
DOI:	10.4166/kjg.2020.123