Percutaneous Transsplenic Embolization of Gastric Varices in Left-sided Portal Hypertension.

Abstract

An 81-year-old man with previously diagnosed cancer of the pancreatic body presented with melena and anemia. Upper gastrointestinal endoscopy showed gastric varices with bleeding in the entire stomach. Contrast-enhanced computed tomography identified a splenic vein occlusion resulting from invasion by the pancreatic body cancer and dilated collateral pathways from the splenic hilum to the gastric fundus. The patient was diagnosed with gastric varices associated with left-sided portal hypertension caused by obstruction of the splenic vein and underwent percutaneous transsplenic embolization with n-butyl-2-cyanoacrylate mixed with lipiodol. Splenic subcapsular hematoma occurred and was treated conservatively. The patient died of advanced cancer 5 months after the procedure, without experiencing rebleeding. Percutaneous transsplenic embolization was effective in treating gastric variceal bleeding caused by left-sided portal hypertension.

• Authors: Yuki Tanaka, Shuji Kariya, Miyuki Nakatani, Yutaka Ueno, Yasuyuki Ono, Takuji Maruyama, Atsushi Komemushi, Noboru Tanigawa
• Journal: Interventional radiology (Higashimatsuyama-shi (Japan) (Interv Radiol (Higashimatsuyama)) Vol. 7 Issue 2 Pg. 58-62 (Jul 01 2022) ISSN: 2432-0935 [Electronic] Japan
• PMID: 36196384 (Publication Type: Case Reports)
• Copyright: © 2022 Japanese Society of Interventional Radiology.