Hemostasis for small intestinal varices caused by extrahepatic portal vein obstruction associated with pancreatic cancer recurrence

Abstract

A 71-year-old woman diagnosed with pancreatic head cancer in 20XX−7 underwent pylorus-preserving pancreaticoduodenectomy. In 20XX−1, CT revealed recurrence in the remnant pancreas, but she declined treatment. In 20XX, she was admitted due to difficulty moving and hematochezia. On day 3, upper endoscopy revealed ruptured small intestinal varices near the anastomosis site. CT showed developed varices in the small intestine, and endoscopic injection sclerotherapy (EIS) with N-butyl-2-cyanoacrylate was performed. Follow-up CT on day 4 showed a treatment effect on the varices and their feeding/draining vessels. Endoscopy on day 9 confirmed variceal disappearance. No rebleeding occurred thereafter. EIS is effective in treating ruptured small intestinal varices.