Hashimoto R, Sofue K, Takeuchi Y, Shibamoto K, Arai Y. Successful balloon-occluded retrograde transvenous obliteration for bleeding duodenal varices using cyanoacrylate. World J Gastroenterol 2013; 19(6): 951-954 [PMID: 23429766 DOI: 10.3748/wjg.v19.i6.951]
Corresponding Author of This Article
Keitaro Sofue, MD, Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. keitarosofue@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rintaro Hashimoto, Keitaro Sofue, Yoshito Takeuchi, Kentaro Shibamoto, Yasuaki Arai, Department of Diagnostic Radiology, National Cancer Center Central Hospital, Tokyo 104-0045, Japan
Author contributions: Hashimoto R wrote the manuscript and performed additional data analysis; Sofue K wrote the manuscript and revised it critically for important intellectual content; Takeuchi Y and Shibamoto K performed procedures; and Arai Y helped by final approval of the version to be published.
Correspondence to: Keitaro Sofue, MD, Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. keitarosofue@yahoo.co.jp
Telephone: +81-3-35422511 Fax: +81-3-35475989
Received: August 19, 2012 Revised: September 11, 2012 Accepted: October 30, 2012 Published online: February 14, 2013
Abstract
A 76-year-old woman with hepatitis C cirrhosis presented with tarry stools and hematemesis. An endoscopy demonstrated bleeding duodenal varices in the second portion of the duodenum. Contrast-enhanced computed tomography revealed markedly tortuous varices around the wall in the duodenum. Several afferent veins appeared to have developed, and the right ovarian vein draining into the inferior vena cava was detected as an efferent vein. Balloon-occluded retrograde transvenous obliteration (BRTO) of the varices using cyanoacrylate was successfully performed in combination with the temporary occlusion of the portal vein. Although no previous publications have used cyanoacrylate as an embolic agent for BRTO to control bleeding duodenal varices, this strategy can be considered as an alternative procedure to conventional BRTO using ethanolamine oleate when numerous afferent vessels that cannot be embolized are present.
