Document Detail


Percutaneous transhepatic obliteration for isolated gastric varices with gastropericardiac shunt: case report.
MedLine Citation:
PMID:  16245014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Management of isolated gastric varices with a gastropericardiac shunt (GPS) has not yet been established. We were able to control a case of isolated gastric varices with a GPS by percutaneous transhepatic obliteration (PTO) using a microcatheter. In this case, the main blood drainage route was not a gastrorenal shunt, so transvenous retrograde obliteration could not be performed and PTO using the microcatheter was applied. Percutaneous transhepatic splenic venography revealed that the gastric varices came from the posterior gastric vein and the main drainage route was a GPS. Gastric varices and their blood supply were superselectively embolized using platinum microcoils and absolute ethanol. Portal venous pressure did not change after PTO because the route from the left gastric vein to the azygos venous system was preserved. Computed tomography 7 days after PTO revealed that the gastric varices were completely obliterated by the thrombi. Plasma ammonia level, arterial ketone body ratio, and indocyanine green retention rate at 15 min were improved. We conclude that PTO using a microcatheter is a rational, effective, and safe therapy for isolated gastric varices with a GPS.
Authors:
F Chikamori; N Kuniyoshi; T Kawashima; S Shibuya; Y Takase
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Abdominal imaging     Volume:  31     ISSN:  0942-8925     ISO Abbreviation:  Abdom Imaging     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-03-30     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9303672     Medline TA:  Abdom Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  249-52     Citation Subset:  IM    
Affiliation:
Tsukuba Portal Hypertension Study Group, Kuniyoshi Hospital, 1-3-4 Kamimachi, Kochi City, Kochi 780-0901, Japan. chikamor@i-kocki.or.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Azygos Vein / radiography
Catheterization
Embolization, Therapeutic / adverse effects,  methods*
Esophageal and Gastric Varices / radiography,  therapy*
Ethanol / therapeutic use
Female
Humans
Portal System / radiography
Solvents / therapeutic use
Splenic Vein / radiography
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Solvents; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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