Pipeline Esophagogastric Varices Secondary to Extrahepatic Portal Vein Obstruction Treated Endoscopically with the Assistance of Transileocolic Obliteration

Endoscopic injection sclerotherapy (EIS) for esophagogastric varices (EGV) was attempted for a 29-year-old man with extrahepatic portal vein obstruction. However, pipeline varices characterized by a large blood flow volume were present, and the sclerosant did not accumulate sufficiently in them. Tra...

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Bibliographic Details
Published in:Internal Medicine 2022/12/01, Vol.61(23), pp.3503-3511
Main Authors: Yokoyama, Shinya, Ishizu, Yoji, Honda, Takashi, Imai, Norihiro, Ito, Takanori, Yamamoto, Kenta, Komada, Tomohiro, Hayashi, Masamichi, Ishigami, Masatoshi
Format: Article
Language:English
Subjects:
Adult
Blood flow
Case Report
endoscopic band ligation
endoscopic injection sclerotherapy
endoscopic variceal ligation
Esophageal and Gastric Varices - complications
Esophageal and Gastric Varices - therapy
Gastrointestinal Hemorrhage - therapy
Humans
Hypertension, Portal - complications
Hypertension, Portal - therapy
Internal medicine
interventional radiology
Ligation
Male
pediatric
portal hypertension
Portal Vein
Sclerosing Solutions - therapeutic use
Sclerotherapy
Varicose Veins - complications
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Description
Summary:Endoscopic injection sclerotherapy (EIS) for esophagogastric varices (EGV) was attempted for a 29-year-old man with extrahepatic portal vein obstruction. However, pipeline varices characterized by a large blood flow volume were present, and the sclerosant did not accumulate sufficiently in them. Transileocolic obliteration (TIO) using coils was performed, but some EGVs and palisading veins remained. Thus, EIS was performed once again immediately after TIO. Since a reduction in the intravariceal blood flow was achieved by preceding TIO, effective injection of sclerosant into the vessels was possible. For pipeline varices difficult to treat endoscopically, combination therapy with TIO may be effective.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9404-22