An emergency hybrid procedure that combines endoscopic treatment with partial splenic embolization for bleeding esophagogastric varices

Radiology Case Reports

article

Fumio Chikamori¹  Atsuki Maeda¹  Niranjan Sharma¹ 

[1] Department of Surgery, Japanese Red Cross Kochi Hospital

关键词: Emergency hybrid procedure;    Splanchnic caput Medusae;    Esophagogastric varices;    Endoscopic injection sclerotherapy;    Partial splenic embolization;    Polycystic liver disease;   

DOI  :  10.1016/j.radcr.2022.02.041

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Management of splenomegaly is important in the treatment of portal hypertension . We report 2 cases who were treated by an emergency hybrid procedure combining endoscopic treatment and partial splenic embolization (PSE) based on a new concept "splanchnic caput Medusae". Case 1 with refractory esophageal variceal bleeding due to alcoholic liver cirrhosis was treated by endoscopic injection sclerotherapy (EIS) with ligation and PSE at the same time. Case 2 with gastric variceal bleeding due to polycystic liver disease was treated by EIS using n-butyl-2-cyanoacrylate and PSE at the same time. Six days after the hybrid procedure, transjugular retrograde obliteration was added. In both cases, post-treatment 3D-CT reconstruction images revealed that the spleen-portal system reversed to almost normal form. We conclude that an emergency hybrid procedure combining endoscopic treatment and PSE is effective for patients with bleeding esophagogastric varices .

【 授权许可】

CC BY|CC BY-NC-ND