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Percutaneous transhepatic obliteration for isolated gastric varices with gastropericardiac shunt: case report.
Abdom Imaging. 2006 Mar-Apr; 31(2):249-52.AI

Abstract

Management of isolated gastric varices with a gastropericardiac shunt (GPS) has not yet been established. We were able to control a case of isolated gastric varices with a GPS by percutaneous transhepatic obliteration (PTO) using a microcatheter. In this case, the main blood drainage route was not a gastrorenal shunt, so transvenous retrograde obliteration could not be performed and PTO using the microcatheter was applied. Percutaneous transhepatic splenic venography revealed that the gastric varices came from the posterior gastric vein and the main drainage route was a GPS. Gastric varices and their blood supply were superselectively embolized using platinum microcoils and absolute ethanol. Portal venous pressure did not change after PTO because the route from the left gastric vein to the azygos venous system was preserved. Computed tomography 7 days after PTO revealed that the gastric varices were completely obliterated by the thrombi. Plasma ammonia level, arterial ketone body ratio, and indocyanine green retention rate at 15 min were improved. We conclude that PTO using a microcatheter is a rational, effective, and safe therapy for isolated gastric varices with a GPS.

Authors+Show Affiliations

Tsukuba Portal Hypertension Study Group, Kuniyoshi Hospital, 1-3-4 Kamimachi, Kochi City, Kochi 780-0901, Japan. chikamor@i-kocki.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

16245014

Citation

Chikamori, F, et al. "Percutaneous Transhepatic Obliteration for Isolated Gastric Varices With Gastropericardiac Shunt: Case Report." Abdominal Imaging, vol. 31, no. 2, 2006, pp. 249-52.
Chikamori F, Kuniyoshi N, Kawashima T, et al. Percutaneous transhepatic obliteration for isolated gastric varices with gastropericardiac shunt: case report. Abdom Imaging. 2006;31(2):249-52.
Chikamori, F., Kuniyoshi, N., Kawashima, T., Shibuya, S., & Takase, Y. (2006). Percutaneous transhepatic obliteration for isolated gastric varices with gastropericardiac shunt: case report. Abdominal Imaging, 31(2), 249-52.
Chikamori F, et al. Percutaneous Transhepatic Obliteration for Isolated Gastric Varices With Gastropericardiac Shunt: Case Report. Abdom Imaging. 2006 Mar-Apr;31(2):249-52. PubMed PMID: 16245014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous transhepatic obliteration for isolated gastric varices with gastropericardiac shunt: case report. AU - Chikamori,F, AU - Kuniyoshi,N, AU - Kawashima,T, AU - Shibuya,S, AU - Takase,Y, PY - 2005/10/26/pubmed PY - 2006/9/29/medline PY - 2005/10/26/entrez SP - 249 EP - 52 JF - Abdominal imaging JO - Abdom Imaging VL - 31 IS - 2 N2 - Management of isolated gastric varices with a gastropericardiac shunt (GPS) has not yet been established. We were able to control a case of isolated gastric varices with a GPS by percutaneous transhepatic obliteration (PTO) using a microcatheter. In this case, the main blood drainage route was not a gastrorenal shunt, so transvenous retrograde obliteration could not be performed and PTO using the microcatheter was applied. Percutaneous transhepatic splenic venography revealed that the gastric varices came from the posterior gastric vein and the main drainage route was a GPS. Gastric varices and their blood supply were superselectively embolized using platinum microcoils and absolute ethanol. Portal venous pressure did not change after PTO because the route from the left gastric vein to the azygos venous system was preserved. Computed tomography 7 days after PTO revealed that the gastric varices were completely obliterated by the thrombi. Plasma ammonia level, arterial ketone body ratio, and indocyanine green retention rate at 15 min were improved. We conclude that PTO using a microcatheter is a rational, effective, and safe therapy for isolated gastric varices with a GPS. SN - 0942-8925 UR - https://www.unboundmedicine.com/medline/citation/16245014/Percutaneous_transhepatic_obliteration_for_isolated_gastric_varices_with_gastropericardiac_shunt:_case_report_ L2 - https://dx.doi.org/10.1007/s00261-005-0372-y DB - PRIME DP - Unbound Medicine ER -