Emborrhoid technique performed on a patient with portal hypertension and chronic hemorrhoidal bleeding as a salvage therapy

CVIR Endovascular

Ana Catarina Carvalho¹  Inês Bolais Mónica²  Filipa Alves e Sousa³  Pedro Marinho Lopes⁴  Pedro Sousa⁴ 

[1] Department of Gastroenterology, Centro Hospitalar Tondela Viseu, Viseu, Portugal;Department of General Surgery, Hospital Distrital da Figueira da Foz, Coimbra, Portugal;Department of Radiology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal;Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, 1169–050, Lisboa, Portugal;Department of Radiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Oporto, Portugal;

关键词: Emborrhoid;    embolization;    hemorrhoidal disease;    portal hypertension;    rectal varices;   

DOI  :  10.1186/s42155-021-00278-8

来源: Springer

【 摘 要 】

BackgroundHemorrhoidal disease most commonly manifests itself with chronic rectal bleeding and, in its most severe and refractory forms, may lead to chronic anaemia with the need for recurrent blood transfusions. The main pathogenetic mechanism involved seems to be arterial hyperflux in the terminal branches that supply the hemorrhoidal plexus. It is based on this principle, that embolization of the superior rectal artery (emborrhoid technique) has recently re-emerged, with very promising results that support its feasibility, treatment efficacy, and safety.Case presentationWe report a case of a patient with both recurrent hemorrhoidal bleeding and portal hypertension with rectal varices, who underwent SRA embolization as a salvage therapy, with significant clinical improvement and no immediate or short-term complications.ConclusionsWe believe that the positive results from our case raise the possibility that the emborrhoid technique could be effective and safe even in patients with portal hypertension, and that it would be clinically relevant to investigate this hypothesis on larger samples with a longer follow-up.

【 授权许可】

CC BY