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Combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration for complicated gastroesophageal varices.
Hepatogastroenterology. 2004 Sep-Oct; 51(59):1506-9.H

Abstract

The treatment of complicated gastroesophageal varices with a gastrorenal shunt and portal hypertensive gastropathy has not yet been established. We were able to control a case of complicated large gastroesophageal varices with gastrorenal shunt and portal hypertensive gastropathy using a combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration. We first applied partial splenic embolization to reduce the hyperdynamic cycle of portal hypertension and to treat thrombocytopenia. We secondarily applied endoscopic embolization for the esophageal varices. Transjugular retrograde obliteration was performed for the gastric varices 14 days after endoscopic embolization. The wedged hepatic venous pressure had not changed after transjugular retrograde obliteration. After the combination treatment, the gastroesophageal varices were successfully obliterated, but portal hypertensive gastropathy did not worsen. The platelets count, arterial ketone body ratio and ICGR15 were improved. Partial splenic embolization was useful to protect side effects of endoscopic embolization and transjugular retrograde obliteration. We conclude that the combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration is a rational, effective and safe treatment for complicated gastroesophageal varices with gastrorenal shunt and portal hypertensive gastropathy.

Authors+Show Affiliations

Tsukuba Portal Hypertension Study Group, Kuniyoshi Hospital, Kochi, Japan. chikamor@i-kochi.or.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15362788

Citation

Chikamori, Fumio, et al. "Combination Treatment of Partial Splenic Embolization, Endoscopic Embolization and Transjugular Retrograde Obliteration for Complicated Gastroesophageal Varices." Hepato-gastroenterology, vol. 51, no. 59, 2004, pp. 1506-9.
Chikamori F, Kuniyoshi N, Kawashima T, et al. Combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration for complicated gastroesophageal varices. Hepatogastroenterology. 2004;51(59):1506-9.
Chikamori, F., Kuniyoshi, N., Kawashima, T., Shibuya, S., & Takase, Y. (2004). Combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration for complicated gastroesophageal varices. Hepato-gastroenterology, 51(59), 1506-9.
Chikamori F, et al. Combination Treatment of Partial Splenic Embolization, Endoscopic Embolization and Transjugular Retrograde Obliteration for Complicated Gastroesophageal Varices. Hepatogastroenterology. 2004 Sep-Oct;51(59):1506-9. PubMed PMID: 15362788.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration for complicated gastroesophageal varices. AU - Chikamori,Fumio, AU - Kuniyoshi,Nobutoshi, AU - Kawashima,Takahiko, AU - Shibuya,Susumu, AU - Takase,Yasuhiro, PY - 2004/9/15/pubmed PY - 2004/10/13/medline PY - 2004/9/15/entrez SP - 1506 EP - 9 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 51 IS - 59 N2 - The treatment of complicated gastroesophageal varices with a gastrorenal shunt and portal hypertensive gastropathy has not yet been established. We were able to control a case of complicated large gastroesophageal varices with gastrorenal shunt and portal hypertensive gastropathy using a combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration. We first applied partial splenic embolization to reduce the hyperdynamic cycle of portal hypertension and to treat thrombocytopenia. We secondarily applied endoscopic embolization for the esophageal varices. Transjugular retrograde obliteration was performed for the gastric varices 14 days after endoscopic embolization. The wedged hepatic venous pressure had not changed after transjugular retrograde obliteration. After the combination treatment, the gastroesophageal varices were successfully obliterated, but portal hypertensive gastropathy did not worsen. The platelets count, arterial ketone body ratio and ICGR15 were improved. Partial splenic embolization was useful to protect side effects of endoscopic embolization and transjugular retrograde obliteration. We conclude that the combination treatment of partial splenic embolization, endoscopic embolization and transjugular retrograde obliteration is a rational, effective and safe treatment for complicated gastroesophageal varices with gastrorenal shunt and portal hypertensive gastropathy. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/15362788/Combination_treatment_of_partial_splenic_embolization_endoscopic_embolization_and_transjugular_retrograde_obliteration_for_complicated_gastroesophageal_varices_ DB - PRIME DP - Unbound Medicine ER -