Severe bleeding from esophageal varices resistant to endoscopic treatment in a non cirrhotic patient with portal hypertension

被引:0
作者
Roberto Caronna
Mario Bezzi
Monica Schiratti
Maurizio Cardi
Giampaolo Prezioso
Michele Benedetti
Federica Papini
Simona Mangioni
Gabriele Martino
Piero Chirletti
机构
[1] Sapienza University of Rome,Department of Surgery "Francesco Durante" – General Surgery N
[2] Sapienza University of Rome,Department of Radiology
来源
World Journal of Emergency Surgery | / 3卷
关键词
Portal Vein; Portal Hypertension; Hepatic Encephalopathy; Transjugular Intrahepatic Portosystemic Shunt; Esophageal Varix;
D O I
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学科分类号
摘要
A non cirrhotic patient with esophageal varices and portal vein thrombosis had recurrent variceal bleeding unsuccessfully controlled by endoscopy and esophageal transection. Emergency transhepatic portography confirmed the thrombosed right branch of the portal vein, while the left branch appeared angulated, shifted and stenotic. A stent was successfully implanted into the left branch and the collateral vessels along the epatoduodenal ligament disappeared. In patients with esophageal variceal hemorrhage and portal thrombosis if endoscopy fails, emergency esophageal transection or nonselective portocaval shunting are indicated. The rare patients with only partial portal thrombosis can be treated directly with stenting through an angioradiologic approach.
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