Radiology Case Reports (Jul 2024)
Percutaneous transhepatic sclerotherapy for ascending colonic varices due to left-sided portal hypertension
- Fumi Sasaki, MD,
- Atsushi Jogo, MD, PhD,
- Akira Yamamoto, MD, PhD,
- Ken Kageyama, MD, PhD,
- Akane Tashiro, MD,
- Yasuhito Mitsuyama, MD,
- Tatsushi Oura, MD,
- Kazuki Matsushita, MD,
- Kazuo Asano, MD,
- Eisaku Terayama, MD,
- Masanori Ozaki, MD,
- Yuki Sakai, MD,
- Shohei Harada, MD,
- Kazuki Murai, MD, PhD,
- Mariko Nakano, MD, PhD,
- Ryuichi Kita, MD, PhD,
- Toshio Kaminou, MD, PhD,
- Yukio Miki, MD, PhD
Affiliations
- Fumi Sasaki, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Atsushi Jogo, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Corresponding author.
- Akira Yamamoto, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Ken Kageyama, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Akane Tashiro, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Yasuhito Mitsuyama, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Tatsushi Oura, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Kazuki Matsushita, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Kazuo Asano, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Eisaku Terayama, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Masanori Ozaki, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Yuki Sakai, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Shohei Harada, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Kazuki Murai, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Mariko Nakano, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Ryuichi Kita, MD, PhD
- Department of Gastroenterology, Red Cross Osaka Hospital, 5-30 Fudegasakicho, Tennoji-ku, Osaka, 543-8555, Japan
- Toshio Kaminou, MD, PhD
- Advanced Imaging and Minimally Invasive Therapy Center, Tsukazaki Hospital, 68-1, Waku, Aboshi-ku, Himeji, Hyogo 671-1227, Japan
- Yukio Miki, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Journal volume & issue
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Vol. 19,
no. 7
pp. 2669 – 2673
Abstract
Left-sided portal hypertension (LSPH) causes varices and splenomegaly due to splenic vein issues. Colonic varices are rare and lack standardized treatment. We report the successful treatment of colonic varices caused by LSPH, by addressing both the afferent and efferent veins. A 70-year-old man with distal cholangiocarcinoma had surgery without splenic vein resection, leading to proximal splenic vein stenosis and varices at multiple locations. Percutaneous transhepatic splenic venography revealed that collateral veins flowed into the ascending colonic varices and returned to the portal vein. Complete thrombosis of the varices was achieved by injecting sclerosants and placing coils in both the afferent and efferent veins. The procedure was safe and effective, with no variceal recurrence. This approach provides a minimally invasive option for treating colonic varices associated with LSPH.
