Percutaneous transsplenic venous embolization of elevated jejunal varices after pancreaticoduodenectomy: A case report

Nobuyuki Higashino, MD; Nobuyuki Kawai, MD, PhD; Tetsuo Sonomura, MD, PhD; Kodai Fukuda, MD; Hirotatsu Sato, MD, PhD; Akira Ikoma, MD, PhD; Manabu Kawai, MD, PhD; Hiroki Minamiguchi, MD, PhD

Radiology Case Reports (Mar 2023)

Percutaneous transsplenic venous embolization of elevated jejunal varices after pancreaticoduodenectomy: A case report

Nobuyuki Higashino, MD,
Nobuyuki Kawai, MD, PhD,
Tetsuo Sonomura, MD, PhD,
Kodai Fukuda, MD,
Hirotatsu Sato, MD, PhD,
Akira Ikoma, MD, PhD,
Manabu Kawai, MD, PhD,
Hiroki Minamiguchi, MD, PhD

Affiliations

Nobuyuki Higashino, MD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan; Corresponding author.
Nobuyuki Kawai, MD, PhD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan
Tetsuo Sonomura, MD, PhD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan
Kodai Fukuda, MD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan
Hirotatsu Sato, MD, PhD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan
Akira Ikoma, MD, PhD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan
Manabu Kawai, MD, PhD: Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
Hiroki Minamiguchi, MD, PhD: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8509, Japan

Journal volume & issue: Vol. 18, no. 3
pp. 737 – 740

Abstract

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Recent advances in chemotherapy and radiotherapy have led to an increase in the number of long-term survivors of pancreatic cancer. However, this has also increased the number of patients suffering from ectopic varices and bleeding owing to left-sided portal hypertension and thrombocytopenia caused by splenomegaly after pancreaticoduodenectomy combined with resection of the splenic vein. A 65-year-old woman with varices of the elevated jejunum due to left sided portal hypertension after pancreaticoduodenectomy had repeated melena, which started about 1 year before admission. We describe the first reported case of percutaneous transsplenic venous embolization using metallic coils, which successfully achieved hemostasis of refractory bleeding from the elevated jejunal varices after pancreaticoduodenectomy.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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