A 70-year-old man with portal hypertension, likely due to extrahepatic portal vein occlusion, was followed up by a family doctor. Esophagogastric varices were diagnosed by endoscopic examination and he was referred to our hospital for treatment of the varices. Although the esophageal varices decreased in volume after repeated courses of endoscopic injection sclerotherapy, massive hematemesis occurred from ruptured gastric varices. Endoscopic hemostasis was resistant for the gastric varices located in the cardia and fornix of the stomach. The dilated left gastric vein was primarily responsible for gastric varices. Percutaneous transhepatic transcatheter variceal embolization via the portal vein was considered to be difficult because of the marked tortuosity and stenosis of the portal trunk with cavernous transformation. The transileocolic obliteration (TIO) method was selected and conducted. After the procedures, a marked hemostatic effect was achieved. TIO is an effective and useful treatment for hemostasis of gastric varices, especially in patients with marked abnormalities of the portal trunk.
A 58-year-old man visited our hospital for follow-up of colonic polyps. Three years ago, colonoscopy demonstrated small erosions at the sigmoid colon and polyps at the descending colon. He has received an a-glucosidase inhibitor for diabetes mellitus for 3 years. Control of his diabetes was poor. Colonoscopy showed multiple elevated lesions similar to submucosal tumors in the rectum and sigmoid colon. Barium-enema study demonstrated the same findings. He was diagnosed with pneumatosis cystoides intestinalis. The α -glucosidase inhibitor was withdrawn because it was suspected to be related to the disorder.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.