Korean J Gastroenterol.  2020 Dec;76(6):331-336. 10.4166/kjg.2020.123.

Percutaneous Trans-splenic Obliteration for Duodenal Variceal bleeding: A Case Report

Affiliations
  • 1Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
  • 2Department of Radiology, Pusan National University Hospital, Busan, Korea

Abstract

Duodenal varices are a serious complication of portal hypertension. Bleeding from duodenal varices is rare, but when bleeding does occur, it is massive and can be fatal. Unfortunately, the optimal therapeutic modality for duodenal variceal bleeding is unclear. This paper presents a patient with duodenal variceal bleeding that was managed successfully using percutaneous trans-splenic variceal obliteration (PTVO). A 56-year-old man with a history of alcoholic cirrhosis presented with a 6-day history of melena. Emergency esophagogastroduodenoscopy revealed a large, bluish mass with a nipple sign in the second portion of the duodenum. Coil embolization of the duodenal varix was performed via a trans-splenic approach (i.e., PTVO). The patient no longer complained of melena after treatment. The duodenal varix was no longer visible at the follow-up esophagogastroduodenoscopy performed three months after PTVO. The use of PTVO might be a viable option for the treatment of duodenal variceal bleeding.

Keyword

Duodenum; Varicose veins; Gastrointestinal hemorrhage; Embolization; therapeutic
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