Successful treatment of rectal varices with antegrade transvenous sclerotherapy via the splenorenal shunt from the transjugular approach

Maciej Pas; Atsushi Jogo; Akira Yamamoto; Norifumi Nishida; Eri Jogo; Ken Kageyama; Etsuji Sohgawa; Yukio Miki

doi:10.1016/j.radcr.2022.08.096

Successful treatment of rectal varices with antegrade transvenous sclerotherapy via the splenorenal shunt from the transjugular approach

Radiol Case Rep. 2022 Sep 30;17(12):4679-4684. doi: 10.1016/j.radcr.2022.08.096. eCollection 2022 Dec.

Authors

Maciej Pas¹, Atsushi Jogo¹, Akira Yamamoto¹, Norifumi Nishida², Eri Jogo¹, Ken Kageyama¹, Etsuji Sohgawa¹, Yukio Miki¹

Affiliations

¹ Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
² Department of Radiology, Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ward, Osaka City, Osaka, 530-0012, Japan.

Abstract

A 74-year-old patient presented with hematochezia and a history of liver cirrhosis with repeated bleeding from esophageal and rectal varices. Endoscopic examination revealed multiple rectal varices with positive red color signs. Ascites, severe portosystemic thrombosis and a splenorenal shunt were diagnosed on a contrast-enhanced dynamic computed tomography examination. From a transjugular approach, we circumvented thrombosed regions by maneuvering double balloon catheters through the shunt and dilated left colic marginal vein. We managed to successfully obliterate the varices.

Keywords: Antegrade transvenous sclerotherapy; Double balloon catheters technique; Liver cirrhosis; Portal thrombosis; Rectal varices; Splenorenal shunt.

Publication types

Case Reports