Percutaneous transhepatic stent for chronic intestinal bleeding from jejunal varices in primary idiophatic superior mesenteric vein stenosis: A case report

Renato Argirò, MD; Leonardo Vattermoli, MD; Francesca Di Pietro, MD; Sara Crociati, MD; Luca Funari, MD; Valentina Perlangeli, MD; Roberto Floris, MD, PhD

Radiology Case Reports (Apr 2022)

Percutaneous transhepatic stent for chronic intestinal bleeding from jejunal varices in primary idiophatic superior mesenteric vein stenosis: A case report

Renato Argirò, MD,
Leonardo Vattermoli, MD,
Francesca Di Pietro, MD,
Sara Crociati, MD,
Luca Funari, MD,
Valentina Perlangeli, MD,
Roberto Floris, MD, PhD

Affiliations

Renato Argirò, MD: Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Rome ''Tor Vergata'', Viale Oxford 81, Rome, 00133, Italy
Leonardo Vattermoli, MD: Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy; Corresponding author.
Francesca Di Pietro, MD: Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
Sara Crociati, MD: Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
Luca Funari, MD: Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
Valentina Perlangeli, MD: Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
Roberto Floris, MD, PhD: Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy; Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome ''Tor Vergata'', Viale Oxford 81, Rome, 00133, Italy; Neurology Unit, Department of Neurology, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy

Journal volume & issue: Vol. 17, no. 4
pp. 1271 – 1275

Abstract

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Jejunal varices are a rare cause of gastrointestinal bleeding. In most cases, they are due to portal hypertension related to liver cirrhosis, less frequently to superior mesenteric vein stenosis (SMV). In this article we describe an unusual case of a 61 year-old male patient who arrived at our emergency department with intermittent variceal bleeding due to jejunal varices causing melena and subsequent chronic anaemia. Patient was indeed discovered to have primary idiopathic superior mesenteric vein stenosis. We managed to treat this patient via SMV stenting through percutaneous transhepatic approach. In cases of upper-GI bleed with negative endoscopy for active bleeding, a contrast-enhanced CT scan should be performed to diagnose jejunal varices and their underlying cause, such as SMV stenosis which is best treated with percutaneous phlebography.

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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