We report a case of successful embolization of jejunal varices that were the cause of massive gastrointestinal bleeding from a choledochojejunostomy site, resulting from obstruction of the extrahepatic portal vein. A 42-year-old man who had undergone choledochojejunostomy for intrahepatic and choledochal stones was readmitted after he started passing massive dark bloody stools. Gastrointestinal endoscopic examination and angiography could not identify the source of bleeding. Percutaneous transhepatic portography showed obstruction of the right branches of the portal vein. The formation of jejunal varices at the site of choledochojejunostomy was revealed by portography and by cholangioscopy, suggesting the varices as the cause of massive bleeding. Bleeding could not be controlled long-term by cholangioscopic sclerosing therapy. We finally stopped the bleeding by embolizing a jejunal vein to the afferent loop.
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http://dx.doi.org/10.1007/s00595-009-4129-z | DOI Listing |
Cureus
December 2024
Department of Surgery, Tokyo Saiseikai Central Hospital, Tokyo, JPN.
Ectopic varices can result from portal vein stenosis following pancreaticoduodenectomy with concomitant portal vein resection reconstruction, and they can cause gastrointestinal bleeding. Although they can sometimes be fatal, various treatments have been reported. This report describes a case in which a percutaneous transhepatic approach was used to simultaneously perform variceal embolization and portal vein stenting in which a favorable outcome was achieved.
View Article and Find Full Text PDFWorld J Gastroenterol
October 2024
Department of Faculty Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia.
Innov Surg Sci
June 2024
Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Objectives: Choledochal malformation (CM) is a rare disease that can lead to malignancy and potential long-term sequelae despite surgical resection. There is no long-term follow-up data on patients after CM resection in Germany. We aimed to determine the long-term outcome of our patients with a duration of follow-up >10 years and focused on long-term sequelae and health-related quality of life (HRQOL).
View Article and Find Full Text PDFCureus
June 2024
Surgery, King George's Medical University, Lucknow, IND.
Ectopic variceal bleeding is a rare cause of postoperative hemorrhage following hepaticojejunostomy and should be differentiated from other causes such as pseudoaneurysms or ulcers. Uncommon complications post-hepaticojejunostomy demand scrupulous attention, and this case report reveals a seldom-documented scenario of jejunal angiodysplasia as an elusive cause of postoperative bleeding. Through a comprehensive examination of the patient's clinical trajectory, diagnostic challenges, and subsequent management, this report contributes to the expanding knowledge base on atypical vascular complications in surgical settings.
View Article and Find Full Text PDFJpn J Radiol
November 2024
Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
Purpose: To evaluate the efficacy and safety of embolization with or without portal vein stenting for bleeding ectopic jejunal varices in the hepatopetal portal collateral due to extrahepatic portal vein occlusion or stenosis after hepatobiliary and pancreatic surgery.
Materials And Methods: This study included consecutive patients who underwent embolization for bleeding ectopic jejunal varices in the hepatopetal collateral due to extrahepatic portal vein occlusion or stenosis after hepatobiliary and pancreatic surgery between September 2012 and December 2020. The safety, technical and clinical success rates (no re-bleeding within 1 month) and re-bleeding-free survival after the first therapy and overall survival were assessed.
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