Bleeding from esophageal varices exacerbated by splenic arterial-venous fistula: complete transcatheter obliterative therapy

Cardiovasc Intervent Radiol. 1980;3(3):97-102. doi: 10.1007/BF02552327.


A cirrhotic patient who had previously undergone both mesocaval shunting and transthoracic esophageal and gastric devascularization with splenectomy (Sugiura procedure) presented with recurring intractable variceal hemorrhage. Diagnostic visceral angiography demonstrated a large splenic arterial-venous fistula and gastroesophageal varices. Transarterial occlusion of the fistula and transheptic obliteration of the varices successfully done at one sitting prevented further bleeding. Follow-up angiography nine months later revealed persistent occlusion of the previous fistula and no evidence of esophageal varices.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Fistula / complications
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / therapy*
  • Catheterization
  • Embolization, Therapeutic / methods*
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / diagnostic imaging
  • Esophageal and Gastric Varices / therapy*
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy
  • Humans
  • Liver Cirrhosis, Alcoholic / complications
  • Male
  • Middle Aged
  • Radiography
  • Splenic Artery* / diagnostic imaging
  • Splenic Vein* / diagnostic imaging