Abstract
Background. A 49-year-old woman with hepatitis C and peptic ulcer disease presented to the emergency department after an onset of sudden massive hematemesis. She had a history of alcohol abuse, but denied any recent excessive drinking.
Investigations. Physical examination, laboratory investigations including complete blood cell counts and liver function tests, esophagogastroduodenoscopy, abdominal angiography and venography, CT scans of the abdomen and pelvis.
Diagnosis. Gastric variceal hemorrhage, severe portal hypertensive gastropathy, splenic vein thrombosis.
Management. Blood transfusion, splenic artery embolization and balloon-occluded retrograde transvenous obliteration of gastric varices. Immediate postprocedural CT scans of the abdomen, with repeat imaging 30 months later.
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References
Hirota, S., Matsumoto, S., Tomita, M., Sako, M. & Kono, M. Retrograde transvenous obliteration of gastric varices. Radiology 211, 349–356 (1999).
Ryan, B., Stockbrugger, R. W. & Ryan, J. M. A pathophysiologic, gastroenterologic, and radiologic approach to the management of gastric varices. Gastroenterology 126, 1175–1189 (2004).
Takahiro, S. et al. Clinical and endoscopic features of gastric varices secondary to splenic vein occlusion. Hepatol. Res. 38, 1076–1082 (2008).
Kanagawa, H. et al. Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration. J. Gastroenterol. Hepatol. 11, 51–58 (1996).
Cho, S. K. The short-term effects of balloon-occluded retrograde transvenous obliteration, for treating gastric variceal bleeding, on portal hypertensive changes: a CT evaluation. Korean J. Radiol. 8, 520–530 (2007).
Akahoshi, T. et al. Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices: a 10-year experience. J. Gastroenterol. Hepatol. 23, 1702–1709 (2008).
Hiraga, N. et al. The long-term outcome of patients with bleeding gastric varices after balloon-occluded retrograde transvenous obliteration. J. Gastroenterol. 42, 663–672 (2007).
Covarelli, P. Splenic vein thrombosis complicated by massive gastric bleeding; treatment with arterious embolization. Am. Surg. 74, 184–185 (2008).
Kiyosue, H. et al. Transcatheter obliteration of gastric varices: part 2. Strategy and techniques based on hemodynamic features. Radiographics 23, 921–937 (2003).
Fukuda, T., Hirota, S. & Sugimura, K. Long-term results of balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephalopathy. J. Vasc. Interv. Radiol. 12, 327–336 (2001).
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Tieu, V., Behrens, G., Ferral, H. et al. A case of complete resolution of gastric varices. Nat Rev Gastroenterol Hepatol 6, 618–622 (2009). https://doi.org/10.1038/nrgastro.2009.144
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DOI: https://doi.org/10.1038/nrgastro.2009.144