Evaluation, Complications and Limitations of Percutaneous Transhepatic Obliteration of Bleeding Gastroesophageal Varices

羊男, 石川; 信義, 伊藤; 驍, 森垣; 寛, 芦田; 満久, 宮井; 英三, 岡本; 明雄, 京; 明義, 朱; 宣夫, 中尾; 光三郎, 杉木

doi:10.5833/jjgs.12.823

Cited by 2 publications

(1 citation statement)

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“…According to a study by Ishikawa et al, portal angiography, performed again after PTO, showed that collateral blood vessels other than embolized veins became dilated and tortuous, and new vascular channels formed within 2 days in all their patients. The portal pressure rapidly rises, and then falls as more collateral blood vessels develop [13]. The recanalization of embolized veins depends on the procedure, embolization material used, and patient's condition.…”

Section: Discussionmentioning

confidence: 99%

A Case of Rapidly Developed Splenomegaly after Percutaneous Transhepatic Obliteration (PTO)

Nojiri¹,

Fujiwara²

2013

J Liver

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A 70-year-old woman underwent Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) for bleeding gastric varices, which was unsuccessful. Then, she underwent Percutaneous Transhepatic Obliteration (PTO) to block the main blood supply route. On the 5 th postoperative day, the white blood cell and platelet counts suddenly fell markedly, and CT showed that the splenomegaly had worsened rapidly after PTO. Since blood flow to the gastric varices was still present, Partial Splenic Embolization (PSE) was performed in an attempt to reduce portal venous blood flow. However, rebleeding from the gastric varices occurred, and so embolization with Histoacryl was performed. Although portal hypertension after PTO is a relatively common event, we report this case because no case has been reported in which massive splenomegaly with leukocytopenia developed within a short period of time.

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Section: Discussionmentioning

confidence: 99%