Balloon occluded retrograde transvenous obliteration and percutaneous transhepatic obliteration for ruptured duodenal varices after operation for rectal cancer with multiple liver metastasis: report of a case

  • Takamura Kazuhito
    Department of Digestive Surgery, Ehime Prefectural Central Hospital
  • Miyake Hidenori
    Department of Surgery, Tokushima City Hospital
  • Mori Hiroki
    Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Terashima Yoshiyasu
    Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Ando Tsutomu
    Department of Surgery, Kochi National Hospital
  • Fujii Masahiko
    Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School
  • Tashiro Seiki
    Department of Surgery, Shikoku Central Hospital
  • Shimada Mitsuo
    Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School

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We report a patient with duodenal varices oozing blood who had undergone low anterior resection of the rectum and resection of the liver tumor because of multiple liver metastasis from rectal cancer 80 months previously. Although endoscopic variceal ligation (EVL) was carried out for the ruptured duodenal varices, their bleeding persisted and hepatic encephalopathy also appeared. Finally, balloon occluded retrograde transvenous obliteration (BRTO) with percutaneous transhepatic obliteration (PTO) was carried out for the duodenal varices. Percutaneous transhepatic portography revealed detailed hemodynamics. Following PTO, the duodenal varices were stagnated by BRTO, and no complications were recognized. No re-bleeding episode has been observed since the treatment. In addition, the hepatic encephalopathy was also improved. J. Med. Invest. 52: 212-217, August, 2005

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