A case of downhill esophageal varices associated with superior vena cava syndrome due to idiopathic fibrosing mediastinitis

DOI 40 References
  • Aoki Kohei
    Department of General Thoracic Surgery, Kawasaki Municipal Hospital Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University
  • Sawafuji Makoto
    Department of General Thoracic Surgery, Kawasaki Municipal Hospital
  • Kamiyama Ikuo
    Department of General Thoracic Surgery, Kawasaki Municipal Hospital
  • Eguchi Keisuke
    Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University
  • Omori Tai
    Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University
  • Narimatsu Yoshiaki
    Department of Radiology, Kawasaki Municipal Hospital

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  • 特発性線維性縦隔炎による上大静脈症候群に合併したDownhill esophageal varicesの1例

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Abstract

A 62-year-old man with superior vena cava (SVC) syndrome due to idiopathic fibrosing mediastinitis underwent the insertion of a self-expanding metallic stent (SEMS) in the SVC. Thirty months after the procedure, recurrence of SVC syndrome with complete obstruction of the SVC was recognized. At around the same time, gastrointestinal endoscopy showed varices involving almost the entire esophagus (F2, Cb, RC (-), Lsmi, Lg (-), E (-)). He had no portal hypertension; therefore, we diagnosed him with downhill esophageal varices due to SVC syndrome. Because there was no bleeding sign, he has been carefully followed up with no medication for 9 years, and no marked change has been observed. Downhill esophageal varices is rare, but it sometimes complicates hematemesis. We should keep downhill esophageal varices in mind when we examine a patient with SVC syndrome.

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