Treatment of bleeding from a portion of pancreatojejunostomy after pancreaticoduodenectomy with division of the splenic vein : two case reports

Kushiya, Hiroki; Noji, Takehiro; Abo, Daisuke; Soyama, Takeshi; Tanaka, Kimitaka; Nakanishi, Yoshitsugu; Asano, Toshimichi; Nakamura, Toru; Tsuchikawa, Takahiro; Okamura, Keisuke; Hirano, Satoshi

Treatment of bleeding from a portion of pancreatojejunostomy after pancreaticoduodenectomy with division of the splenic vein : two case reports

Kushiya, Hiroki; Noji, Takehiro; Abo, Daisuke et al.

Surgical case reports, 2019, 5(1), 128

Permalink : https://hdl.handle.net/2115/75509

このアイテムのアクセス数:680件（2026-08-19 06:38 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/75509
タイトル	Treatment of bleeding from a portion of pancreatojejunostomy after pancreaticoduodenectomy with division of the splenic vein : two case reports
著者	Kushiya, Hiroki ; Noji, Takehiro ; Abo, Daisuke ; Soyama, Takeshi ; Tanaka, Kimitaka ; Nakanishi, Yoshitsugu ; Asano, Toshimichi ; Nakamura, Toru ; Tsuchikawa, Takahiro ; Okamura, Keisuke ; Hirano, Satoshi
著者名 Kushiya, Hiroki
e-Rad_Researcher 10739296 著者名 Noji, Takehiro
e-Rad_Researcher 30399844 著者名 Abo, Daisuke
e-Rad_Researcher 00794059 著者名 Soyama, Takeshi
e-Rad_Researcher 10758642 著者名 Tanaka, Kimitaka
e-Rad_Researcher 40447058 著者名 Nakanishi, Yoshitsugu
e-Rad_Researcher 10756688 著者名 Asano, Toshimichi
e-Rad_Researcher 70645796 著者名 Nakamura, Toru
e-Rad_Researcher 50507572 著者名 Tsuchikawa, Takahiro
e-Rad_Researcher 90724401 著者名 Okamura, Keisuke
e-Rad_Researcher 50322813 著者名 Hirano, Satoshi
言語	英語
キーワード	Pancreaticoduodenectomy
	Left-sided portal hypertension
	Interventional radiology
	Intestinal bleeding
発行日	2019-08-08
出版者	Springer (SpringerOpen)
収録物名	Surgical case reports
巻(号)	5(1)
ページ	128
抄録	Background There is no definitive strategy for gastrointestinal bleeding due to left-sided portal hypertension after pancreaticoduodenectomy (PD) for pancreatic cancer (PC) with concomitant portal vein resection (PVR). Case presentation Case 1: A 70-year-old woman underwent a PD for PC with PVR. Seven years after her surgery, she suffered severe anemia with suspected gastrointestinal bleeding. Computed tomography scan (CT) revealed varices at a portion of the pancreaticojejunostomy (PJ). Angiography revealed that splenic venous flow drained into the varices and then into the portal vein. A diagnosis of bleeding varices of the PJ due to left-sided portal hypertension was made. Following a partial splenic artery embolization, her anemia improved. Case 2: An 80-year-old male underwent a PD for pancreatic head cancer combined with resection of the confluence of the portal and splenic veins with a reconstruction between the portal and superior mesenteric veins. Eighteen months after his surgery, he developed melena with negative endoscopy findings in his large and small bowel. CT revealed varices at the site of the PJ that communicated with the jejunal and portal veins. He underwent obliteration of the varices via a trans-portal-venous approach. As a result, he remained without melena until he died of PC 17 months after the embolization. Conclusions Left-sided portal hypertension following a PD with bleeding varices can be treated by interventional radiology with minimal invasiveness.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution 4.0 International
PISSN	2198-7793
関連情報	PMID 31396775
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s40792-019-0687-5