Child C肝硬変併存反復性Portal hypertensive gastropathy出血に対する部分的脾動脈塞栓術の試み

抄録

It is thought that it is not easy to stop bleeding from severe portal hypertensive gastropathy (PHG) due to liver cirrhosis by conservative treatment et al. It has been already reported that PHG is pathologically the dilated vessels in gastric mucosa. Therefore, it is thought that partial splenic embolization (PSE) is one of useful treatment for bleeding from PHG because the pressure of the portal vein was decreased after PSE. This study is to determine the usefulness of PSE to stop the bleeding from PHG. From November 1997 to May 1999, five patients have hematoemesis and/or melena due to bleeding from severe PHG by panendoscope. Primary diseases in all patients were liver cirrhosis with Child C. It was to embolize 30%-50% of spleen by PSE. Four patients had severe hypersplenism and residual one did mild one by angiography et al. As a result, in four cases with severe hypersplenism, the bleeding was just stopped after PSE. In residual one with mild splenomegaly, bleeding was just stopped after PSE. However, two days after PSE, the patient was died due to hepatic coma. Therefore, it is thought that PSE is useful to stop the bleeding from PHG in the cases with severe splenomegaly.