A patient with hepatocellular carcinoma plus liver cirrhosis, who developed rectal variceal rupture after ligation therapy for esophageal varices

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  • 食道静脈瘤結紮術後に直腸静脈瘤破裂をきたした肝癌合併肝硬変の１例
  • 症例報告 食道静脈瘤結紮術後に直腸静脈瘤破裂をきたした肝癌合併肝硬変の1例
  • ショウレイ ホウコク ショクドウ ジョウミャクリュウ ケッサツジュツゴ ニ チョクチョウ ジョウミャクリュウ ハレツ オ キタシタ カンガン ガッペイ カンコウヘン ノ 1レイ

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Abstract

A 73 years old woman with liver cirrhosis was admitted to our hospital for the purpose of radiofrequency ablation (RFA) for her hepatocellular carcinoma (HCC) . However, as waiting for the RFA therapy for HCC, she developed rupture of esophageal varices and underwent endoscopic variceal ligation (EVL) . Then, 38 hours after the EVL of esophageal varices, melena occurred. Since colonoscopy and abdominal CT revealed that the melena was caused by a rupture of giant rectal varices, we thought that an endoscopic treatment of the variceal rupture was not suitable. Abdominal angiography indicated a portosystemic shunt from inferior mesenteric vein to middle rectal vein. We then treated for the rectal varices with the percutaneous transhepatic obliteration (PTO) with coil and sclerosant. After PTO, the long-awaited RFA was performed for HCC finally. Now, at 6 months after these therapies, the patient remains free from relapses of melena and HCC.<br>

Journal

  • Kanzo

    Kanzo 48 (3), 97-101, 2007

    The Japan Society of Hepatology

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