ArticleRadiology case reports2023
Percutaneous transhepatic obliteration for life-threatening bleeding after endoscopic variceal ligation in a patient with severe esophagogastric varices.
Article in Radiology case reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Management Strategies for Refractory Esophageal Varices.DEN open · 2026Review
- Observational
- Efficacy of transjugular intrahepatic portosystemic shunts in treating cirrhotic esophageal-gastric variceal bleeding.World journal of gastrointestinal surgery · 2024Article
- Guiding role of esophageal variceal diameter in treatment of endoscopic ligation: an animal experimental study.Scientific reports · 2024Article
- Neutrophil-lymphocyte ratio predict outcome of upper gastrointestinal bleeding in emergency.Frontiers in medicine · 2024Article
- Interventional radiology using endoscopy: Blood supply route-targeted endoscopic injection sclerotherapy with multiple ligations for giant esophagogastric varices.Radiology case reports · 2023Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We report a case of life-threatening bleeding after endoscopic variceal ligation (EVL) in a patient with severe esophagogastric varices that was treated by percutaneous transhepatic obliteration (PTO). 3D-CT reconstruction image demonstrated giant esophagogastric varices and gastrorenal shunt. The spleen volume was 813 mL, and the liver volume was 716 mL; giving a spleen/liver volume ratio of 1.1. A strategy of stepwise partial splenic artery embolization (PSE) was employed to control portal venous pressure based on the concept of splanchnic caput Medusae. The S/L ratio improved to 0.3 by stepwise PSE. Subsequently, EVL was performed for esophageal varices, but bleeding occurred afterward, and hemostasis using a Sengstaken-Blakemore tube was attempted. Subsequently, PTO was performed the following day for embolization of the left gastric vein. Gastric varices and gastrorenal shunt were intentionally reserved to avoid portal venous pressure increase. After the procedure, his condition improved. We conclude, in patients with severe esophagogastric varices, prudent management of the splenomegaly and the collateral tracts is necessary.
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