APPEARANCE OF RECTAL VARICES IN EXTRAHEPATIC PORTAL OBSTRUCTION AFTER TREATMENT FOR ESOPHAGO-GASTRIC VARICES : A CASE REPORT
スポンサーリンク
概要
- 論文の詳細を見る
We report a case of rectal varices that developed after endoscopic injection sclerotherapy (EIS) and Hassab's operation for esophageal varices with extrahepatic portal obstruction. A 54-year-old woman was admitted to our hospital in September 1997 for treatment of hematochezia. Emergent colonoscopy revealed tortuous rectal varices with a white plug. Angiography revealed that rectal varices were provided with backward blood flow by the inferior mesenteric vein due to extrahepatic portal obstruction. In this case, previous treatment, EIS and Hassab's operation, for esophago-gastric varices might have inhibited the development of collaterals apart from surface of gastrointestinal tract, such as para-esophageal collateral veins or spleno-renal shunt. Since the thrombus in the extrahepatic portal vein causes strong pressure on inferior mesenteric vein which is connected to the inferior vena cava via the inferior rectal vein, rectal varices might be developed. In this case, it was considered that rectal varices were not treated enough by endoscopic therapy because of regurgitant hyper blood flow against portal venous pressure. Therefore, rectal transection was performed. After the treatment, the patient suffered no further episodes of bleeding from rectal varices.
- 福島医学会の論文
著者
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SUZUKI Tomohiro
Department of Internal Medicine II, Fukushima Medical University School of Medicine
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Obara Katsutoshi
Department Of Endoscopy Fukushima Medical University Hospital
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Saito Ayako
Department Of Cell Physiology Kyorin University School Of Medicine
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Abe Tsuyoshi
Department Of Cardiology Graduate School Of Medical Science Kanazawa University
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Sato Yukio
Department Of Advanced Materials Science Graduate School Of Frontier Science The University Of Tokyo
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Saito Takuro
Department Of Forensic Medicine Tokai University School Of Medicine
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Katakura Kyoko
Department Of Internal Medicine 2 Fukushima Medical University School Of Medicine
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Watanabe Kenya
Department Of Internal Medicine Ii Fukushima Medical University School Of Medicine
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Shishido Hideo
Department Of Hematology Meitetsu Hospital
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Takagi Tadayuki
Department Of Gastroenterology Aichi Cancer Center Hospital
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Tsuchiya Takao
Department Of Electronic Engineering Okayama Universiy
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Kasukawa Reiji
Department Of Internal Medicine 2 Fukushima Medical University School Of Medicine
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Saito Hiroyuki
Department Of Anesthesiology Gunma University School Of Medicine
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Shibukawa Goro
Department Of Gastroenterology And Rheumatology Fukushima Medical University School Of Medicine
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Ishikawa Hidemasa
Department Of Gastroenterology And Rheumatology Fukushima Medical University School Of Medicine
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Suzuki Tomohiro
Department Of Basic Pathology Fukushima Medical University School Of Medicine
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Goto Mitsukazu
Department of Organ Regererative Surgery
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IRISAWA ATSUSHI
Department of Gastroenterology and Rheumatology
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WATANABE KENYA
Department of Gastroenterology, Fujita General Hospital
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ABE TSUYOSHI
Department of Surgery I, Fukushima Medical University School of Medicine
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SAITO TAKURO
Department of Surgery I, Fukushima Medical University School of Medicine
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