内視鏡的静脈瘤結紮術(EVL)と経回結腸静脈的塞栓術(TIO)が有効であった十二指腸静脈瘤破裂の1例

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  • AN EFFECTIVE CASE OF BLEEDING FROM DUODENAL VARICES TREATED BY ENDOSCOPIC VARICEAL LIGATION AND TRANS ILEOCOLIC VEIN OBLITERATION

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A 64-year-old female with liver cirrhosis was admitted with complaint of hematemesis and melena. Altough S-B tube was introduced, hemostasis was unsuccessful. Endoscopic examination revealed varices like a submucosal tumor in the second portion of duodenum. There was a bleeding point on the varices, and we performed EVL for it. After that, bleeding just stopped and general status improved. We perf omed TIO additionaly one day after EVL for fear of rebleeding. Portography on TIO showed a dilated inferior pancreaticoduodenal vein and blood flow was completely blocked at EVL sites. After EVL and TIO, duodenoscopy revealed the varices disappeared and scar formation occuured. Combination therapy of EVL and TIO was considered to be effective to rapture of the duodenal varices.

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