Verification of thrombus formation just after endoscopic injection sclerotherapy with ligation for esophagogastric varices by venous phase of left gastric arteriography

Radiology Case Reports

article

Fumio Chikamori¹  Shunsuke Kanazawa¹  Niranjan Sharma¹ 

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

关键词: Left gastric arteriography;    Emergency hybrid procedure;    Splanchnic caput Medusae;    Esophagogastric varices;    Endoscopic injection sclerotherapy with ligation;    Left gastric artery embolization;   

DOI  :  10.1016/j.radcr.2022.07.098

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Management of hepatic venous pressure gradient (HVPG) is important in the treatment of portal hypertension . We report a case that was treated by a hybrid procedure combining endoscopic injection sclerotherapy with ligation (EISL), left gastric artery embolization (LGE), and partial splenic artery embolization (PSE) based on a new concept ``splanchnic caput Medusae .'' The venous phase of left gastric arteriography just after EISL demonstrated thrombus formation in the gastric varices and the cardiac branch of the left gastric vein . The para-esophageal vein and lesser curvature branch of the left gastric vein were not affected. HVPG decreased from 14 to 11 mmHg immediately after LGE and PSE. 3D-CT reconstruction portal image revealed that the portal system reversed to almost normal form. This is the first case report in which thrombus formation in gastric varices and cardiac branch just after EISL could be demonstrated by the venous phase of left gastric arteriography.

【 授权许可】

CC BY|CC BY-NC-ND