Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Duodenal Variceal Bleeding - A Case Report and Literature Review.

Kyung Kyu Lee, Jae Yong Park, Woo Sun Choi, Young Youn Cho
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Abstract

Duodenal varices are uncommon complications of portal hypertension. Although duodenal variceal bleeding is infrequent, it is a life-threatening condition with a high mortality rate. Non-surgical methods for duodenal variceal bleeding include endoscopic band ligation, endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and retrograde transvenous obliteration. On the other hand, an optimal treatment strategy for this rare condition has not been established. A 38-year-old male with a history of alcoholic liver cirrhosis presented with hematemesis. An emergency esophagogastroduodenoscopy (EGD) revealed large, multiple varices in the second portion of the duodenum, and plug-assisted retrograde transvenous obliteration (PARTO) was performed accordingly. Gastrointestinal bleeding was resolved after the procedure. Follow-up EGD conducted after 11 weeks revealed complete obliteration of the previously observed duodenal varices. PARTO may be considered a viable option for treating duodenal variceal bleeding.

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用于治疗十二指肠静脉曲张出血的塞子辅助逆行经静脉阻断术--病例报告和文献综述。
十二指肠静脉曲张是门静脉高压症不常见的并发症。虽然十二指肠静脉曲张出血并不常见,但它是一种威胁生命的疾病,死亡率很高。治疗十二指肠静脉曲张出血的非手术方法包括内镜带结扎术、内镜硬化剂治疗、经颈静脉肝内门体分流术和逆行经静脉阻塞术。另一方面,针对这种罕见病症的最佳治疗策略尚未确立。一名有酒精性肝硬化病史的 38 岁男性出现吐血。急诊食管胃十二指肠镜(EGD)检查发现十二指肠第二段有巨大的多发性静脉曲张,于是进行了塞子辅助逆行经静脉阻断术(PARTO)。术后,消化道出血症状得到缓解。11 周后进行的随访胃肠造影显示,之前观察到的十二指肠静脉曲张完全消失。PARTO 可被视为治疗十二指肠静脉曲张出血的可行方案。
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