Document Detail


Combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration for complicated gastroesophageal varices.
MedLine Citation:
PMID:  15362788     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment of complicated gastroesophageal varices with a gastrorenal shunt and portal hypertensive gastropathy has not yet been established. We were able to control a case of complicated large gastroesophageal varices with gastrorenal shunt and portal hypertensive gastropathy using a combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration. We first applied partial splenic embolization to reduce the hyperdynamic cycle of portal hypertension and to treat thrombocytopenia. We secondarily applied endoscopic embolization for the esophageal varices. Transjugular retrograde obliteration was performed for the gastric varices 14 days after endoscopic embolization. The wedged hepatic venous pressure had not changed after transjugular retrograde obliteration. After the combination treatment, the gastroesophageal varices were successfully obliterated, but portal hypertensive gastropathy did not worsen. The platelets count, arterial ketone body ratio and ICGR15 were improved. Partial splenic embolization was useful to protect side effects of endoscopic embolization and transjugular retrograde obliteration. We conclude that the combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration is a rational, effective and safe treatment for complicated gastroesophageal varices with gastrorenal shunt and portal hypertensive gastropathy.
Authors:
Fumio Chikamori; Nobutoshi Kuniyoshi; Takahiko Kawashima; Susumu Shibuya; Yasuhiro Takase
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  51     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2004 Sep-Oct
Date Detail:
Created Date:  2004-09-14     Completed Date:  2004-10-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1506-9     Citation Subset:  IM    
Affiliation:
Tsukuba Portal Hypertension Study Group, Kuniyoshi Hospital, Kochi, Japan. chikamor@i-kochi.or.jp
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation
Embolization, Therapeutic*
Esophageal and Gastric Varices / radiography,  therapy*
Fluoroscopy
Gastroscopy*
Humans
Hypertension, Portal / radiography,  therapy
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Jugular Veins / radiography
Liver Cirrhosis, Alcoholic / complications,  radiography,  therapy
Liver Function Tests
Male
Middle Aged
Phlebography
Renal Veins / radiography
Retreatment
Sclerotherapy
Splenic Vein* / radiography
Stomach / blood supply
Tomography, X-Ray Computed
Ultrasonography, Doppler, Pulsed

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