An emergency hybrid procedure that combines endoscopic treatment with partial splenic embolization for bleeding esophagogastric varices

Autor: Fumio Chikamori, Atsuki Maeda, Niranjan Sharma
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Radiology Case Reports, Vol 17, Iss 5, Pp 1640-1645 (2022)
Druh dokumentu: article
ISSN: 1930-0433
DOI: 10.1016/j.radcr.2022.02.041
Popis: Management of splenomegaly is important in the treatment of portal hypertension. We report 2 cases who were treated by an emergency hybrid procedure combining endoscopic treatment and partial splenic embolization (PSE) based on a new concept ''splanchnic caput Medusae''. Case 1 with refractory esophageal variceal bleeding due to alcoholic liver cirrhosis was treated by endoscopic injection sclerotherapy (EIS) with ligation and PSE at the same time. Case 2 with gastric variceal bleeding due to polycystic liver disease was treated by EIS using n-butyl-2-cyanoacrylate and PSE at the same time. Six days after the hybrid procedure, transjugular retrograde obliteration was added. In both cases, post-treatment 3D-CT reconstruction images revealed that the spleen-portal system reversed to almost normal form. We conclude that an emergency hybrid procedure combining endoscopic treatment and PSE is effective for patients with bleeding esophagogastric varices.
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