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Stroke after percutaneous transhepatic variceal obliteration of esophageal varix in Caroli syndrome
Lee, Yoo Min,Lee, Yoon,Choe, Yon Ho The Korean Pediatric Society 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.11
Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.
Stroke after percutaneous transhepatic variceal obliteration of esophageal varix in Caroli syndrome
이유민,이윤,최연호 대한소아청소년과학회 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.11
Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However,the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.
간문맥혈전을 동반한 침윤성 간세포암에서 경피적 경간 폐색술 후 장간맥 혈전의 진행
김희언 ( Hee Yeon Kim ),박정화 ( Chung Hwa Park ),이승원 ( Sung Won Lee ),송도선 ( Do Seon Song ),송명준 ( Myeong Jun Song ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ),배시현 ( Si Hyun Bae ),오정석 ( Jung Suk Oh ),천호종 대한간암학회 2012 대한간암학회지 Vol.12 No.2
Percutaneous transhepatic obliteration of gastroesophageal varices is one of the effective emergency procedure when endoscopic therapy is not indicated or has been failed. One of the major complications of this procedure is portal thrombosis. A 53-year-old male with hepatitis B virus infection was diagnosed of infiltrative hepatocellular carcinoma with right portal vein thrombosis. On the next day after being hospitalization, the patient developed variceal bleeding. With medical management, endoscopic therapy was initially attempted, however, it ended in failure. Emergency percutaneous transhepatic obliteration of bleeding gastroesophageal varices was considered as a next option. Bleeding from gastroesophageal varices was stopped after percutaneous obliateration, however, portal thrombosis was extended to splenic vein or superior mesenteric veins.
박승현,김도영,이신재,원종윤,박성일,이도연,김만득 대한영상의학회 2014 대한영상의학회지 Vol.71 No.5
Variceal bleeding is an unusual complication of ileal conduits. We report a case in which recurrent stomal variceal hemorrhage from an ileal conduit for bladder cancer was successfully treated by percutaneous transhepatic obliteration (PTO) using microcoils and N-butyl cyanoacrylate. Therefore, PTO can be one treatment option to prevent recurrent stomal variceal bleeding from ileal conduits.
임동훈,김동현,김민석,김철성 대한영상의학회 2013 Korean Journal of Radiology Vol.14 No.1
Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.
A case report of bleeding from duodenal varices treated with percutaneous transhepatic obliteration
Ji Hyun Lee,Tae Hwan Kim,Jong Won Choi,Sun Young Kim,Jin Young Choi,Chun Kyon Lee,Byung Kyu Park,Jae Bok Chung 소화기인터벤션의학회 2019 Gastrointestinal Intervention Vol.8 No.4
Duodenal varices are ectopic in nature and account for 40% of all ectopic bleeding cases. Ectopic variceal bleeding is rare (1%–5% of all variceal bleeding cases). The three principle approaches used to treat duodenal varices are endoscopic procedures, interventional radiological methods, and surgical interventions. A 59-year-old male with alcoholic liver cirrhosis and chronic hepatitis B infection visited our gastroenterology department with melena. Gastroduodenoscopy and computed tomography identified varices in the second part of the duodenum. We performed percutaneous transhepatic obliteration using glue and coil embolization, which obliterated the varices and resulted in immediate hemostasis. However, 3 months later, he re-visited presenting with newly developed duodenal varices and underwent endoscopic injection sclerotherapy.
A case report of bleeding from duodenal varices treated with percutaneous transhepatic obliteration
Ji Hyun Lee,Tae Hwan Kim,Jong Won Choi,Sun Young Kim,Jin Young Choi,Chun Kyon Lee,Byung Kyu Park,Jae Bok Chung 소화기인터벤션의학회 2019 International journal of gastrointestinal interven Vol.8 No.4
Duodenal varices are ectopic in nature and account for 40% of all ectopic bleeding cases. Ectopic variceal bleeding is rare (1%–5% of all variceal bleeding cases). The three principle approaches used to treat duodenal varices are endoscopic procedures, interventional radiological methods, and surgical interventions. A 59-year-old male with alcoholic liver cirrhosis and chronic hepatitis B infection visited our gastroenterology department with melena. Gastroduodenoscopy and computed tomography identified varices in the second part of the duodenum. We performed percutaneous transhepatic obliteration using glue and coil embolization, which obliterated the varices and resulted in immediate hemostasis. However, 3 months later, he re-visited presenting with newly developed duodenal varices and underwent endoscopic injection sclerotherapy.