A case of rectal varices treated with percutaneous transhepatic obliteration

Abstract

A 59-year-old man diagnosed with alcoholic liver cirrhosis (LC) and rectal varices (RV) was admitted to our hospital because of recurrence of RV. He underwent endoscopic variceal ligation for RV. An abdominal CT scan suggested the inferior mesenteric vein had hepatofugal flow and mainly supplied RV. The blood flow rate of the RV was 20cm/sec as measured by Color Doppler ultrasonography, which was too fast to treat with endoscopic injection sclerotherapy. Therefore, we decided to treat the RV with percutaneous transhepatic obliteration (PTO). Moreover, partial splenic artery embolization was performed for portal hypertension before PTO. PTO was successfully performed, and the RV was embolized using ethanolamine oleate and microcoils. Colonoscopy revealed the complete disappearance of RV after PTO.