十二指腸静脈瘤破裂に対するダブルバルーン内視鏡を用いた 内視鏡的静脈瘤結紮術の経験

會澤 信弘; 岩田 恵典; 高嶋 智之; 坂井 良行; 榎本 平之; 河野 友影; 中村 志郎; 松本 譽之; 三輪 洋人; 西口 修平

doi:10.11280/gee.55.1478

EXPERIENCE OF A RUPTURED DUODENAL VARIX ON THE THIRD PORTION SUCCESSFULLY TREATED WITH ENDOSCOPIC VARICEAL LIGATION USING DOUBLE BALLOON ENTEROSCOPY

Nobuhiro AIZAWA, Yoshinori IWATA, Tomoyuki TAKASHIMA, Yoshiyuki SAKAI, Hirayuki ENOMOTO, Tomokage KOHNO, Shiro NAKAMURA, Takayuki MATSUMOTO, Hiroto MIWA, Shuhei NISHIGUCHI

Author information

Nobuhiro AIZAWA
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine.
Department of Endoscopy Center, Hyogo College of Medicine.
Yoshinori IWATA
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine.
Department of Endoscopy Center, Hyogo College of Medicine.
Tomoyuki TAKASHIMA
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine.
Yoshiyuki SAKAI
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine.
Hirayuki ENOMOTO
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine.
Tomokage KOHNO
Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine.
Shiro NAKAMURA
Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine.
Takayuki MATSUMOTO
Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine.
Hiroto MIWA
Department of Endoscopy Center, Hyogo College of Medicine.
Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine.
Shuhei NISHIGUCHI
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine.

JOURNAL FREE ACCESS

2013 Volume 55 Issue 4 Pages 1478-1483

DOI https://doi.org/10.11280/gee.55.1478

Details

Abstract

A 72-year-old man was admitted to our hospital with tarry stools. He had been followed up as a patient with decompensated liver cirrhosis and hepatocellular carcinoma. He had a history of endoscopic injection sclerotherapy for esophageal varices 6 years before this episode and had undergone TACE for heaptocellular carcinoma 7 times during the period. Computed tomography showed dilated varices is the duodenum. Gastrointestinal endoscopic examination revealed a ruptured nodular varix with a white plug on the third portion of the duodenum. The varices were treated with the endoscopic variceal ligation (EVL) method using double balloon enteroscopy.
After the EVL treatment endoscopic examination demonstrated disappearance of the duodenal varix with post therapeutic scarrings. EVL using double balloon enteroscopy is considered as a therapeutic option for rupture of duodenal varix in emergency, especially for the patients with decompensated liver cirrhosis.

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