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Korean J Pancreas Biliary Tract > Volume 18(3):2013 > Article
The Korean Journal of Pancreas and Biliary Tract 2013;18(3):37-40.
휘플씨 수술후 발생한 공장 정맥류 출혈을 문맥 스텐트 및 내시경 경화술로 치료한 1예
나현진1, 강원식1, 최자성1, 강버들1, 조재희1,2, 박경원1, 김현범3, 김희만1,2
1명지병원 소화기내과, 2관동대학교 의과대학 내과학교실, 3국립암센터 영상의학교실"
Jejunal Varix Bleeding after Pancreaticoduodenectomy Successfully Treated with Portal Vein Stent Placement and Endoscopic Sclerotherapy
Hyun Jin Na1, Won Sik Kang1, Ja Sung Choi1, Beo Deul Kang1, Jae Hee Cho1,2, Kyung Won Park1, Hyun Boem Kim3, Hee Man Kim1,2
1Division of Gastroenterology, Department of Internal Medicine, Myongji Hospital, Goyang, Korea, 2Department of Internal Medicine, Kwandong University College of Medicine, Gangneung, Korea 3Department of Radiology, National Cancer Center, Goyang, Korea
ABSTRACT
A 57-year-old woman, who had undergone pancreaticoduodenectomy and chemo-radiation therapy for common bile duct cancer 7 years ago, visited our institution for hematochezia. Esophagogastroduodenoscopy and colonoscopy couldn't detect bleeding focus and abdomen computed tomography showed stenosis of portal vein and jejunal varices. Subsequent to percutaneous transhepatic portography, we dilated the extrahepatic portal vein using a balloon catheter and placed a stent. The patient had hematochezia after two weeks again. EGD was performed and a new stigmata was found at the afferent loop of small bowel. We injected histoacryl and no more bleeding was occurred. For the treatment of jejunal varices, a less invasive approach, such as portal stent placement and endoscopic sclerotherapy can be a useful tool, especially after abdominal surgery.
Keywords: jejunal varices, portal vein stenosis, sclerotherapy, pancreaticoduodenectomy
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