Treatment of bleeding rectal varices with transumbilical venous obliteration of the inferior mesenteric vein.

Abstract

A 56-year-old male with alcohol-induced liver cirrhosis developed rectal varices. He had a prior history of treatment for esophageal varices with endoscopic variceal ligation. Despite the repeated treatment for rectal varices with endoscopic variceal ligation, endoscopic injection sclerotherapy, and surgery, the bleeding from the rectal varices could not be controlled. Multidetector-row computed tomography and 3D-angiography revealed the hemodynamic profile of the rectal varices. We next approached the rectal varices through the umbilical vein on the abdominal wall, and successfully embolized the varices continuing from the inferior mesenteric vein using coils and a 5% solution of ethanolamine oleate with iopamidol.

• Authors: Naotaka Hashimoto, Tomohiko Akahoshi, Masahiro Kamori, Morimasa Tomikawa, Daisuke Yoshida, Yoshihiro Nagao, Kazutoyo Morita, Hiroto Kayashima, Toru Ikegami, Tomoharu Yoshizumi, Akinobu Taketomi, Ken Shirabe, Yoshihiko Maehara
• Journal: Surgical laparoscopy, endoscopy & percutaneous techniques (Surg Laparosc Endosc Percutan Tech) Vol. 23 Issue 3 Pg. e134-7 (Jun 2013) ISSN: 1534-4908 [Electronic] United States
• PMID: 23752023 (Publication Type: Case Reports, Journal Article)

Chemical References

• Oleic Acids
• Sclerosing Solutions
• ethanolamine oleate

Topics

• Endoscopy (methods)
• Gastrointestinal Hemorrhage (diagnostic imaging, therapy)
• Humans
• Injections, Intralesional
• Male
• Middle Aged
• Multidetector Computed Tomography
• Oleic Acids (administration & dosage)
• Rectal Diseases (diagnostic imaging, therapy)
• Rectum (blood supply, diagnostic imaging)
• Sclerosing Solutions (administration & dosage)
• Sclerotherapy (methods)
• Umbilical Veins
• Varicose Veins (diagnostic imaging, therapy)