Duodenal variceal bleeding after balloon-occluded retrograde transverse obliteration: Treatment with transjugular intrahepatic portosystemic shunt
- Affiliated Author(s)
- 장병국; 정우진; 황재석; 김영환
- Alternative Author(s)
- Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok; Kim, Young Hwan
- Journal Title
- World Journal of Gastroenterology
- ISSN
- 1007-9327
- Issued Date
- 2012
- Abstract
- We report a case of duodenal varix bleeding as a long
term complication of balloon occluded retrograde transvenous
obliteration (BRTO), which was successfully
treated with a transjugular intrahepatic portosystemic
shunt (TIPS). A 57-year-old man was admitted to the
emergency room suffering from melena. He had undergone
BRTO to treat gastric varix bleeding 5 mo before
admission. Endoscopy and a computed tomography
(CT) scan showed complete obliteration of the gastric
varix, but the nodular varices in the second portion
of the duodenum expanded after BRTO, and spurting
blood was seen. TIPS was performed for treatment
of duodenal variceal bleeding, because attempts at
endoscopic varix ligation were unsuccessful. The postoperative
course was uneventful and the patient was
discharged without complications. A follow up CT scan
obtained 21 mo after TIPS revealed a patent TIPS tract
and complete obliteration of duodenal varices, but multinodular
hepatocellular carcinoma had developed. He
died of hepatic failure 28 mo after TIPS.
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