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Ruptured Duodenal Varices Successfully Treated with Balloon-Occluded Retrograde Transvenous Obliteration: Usefulness of Microcatheters

Tetsuo Sonomura1, Koushi Horihata1, Kunihiro Yamahara2, Toshio Dozaiku2, Takashi Toyonaga2, Takashi Hiroka2 and Morio Sato3

1 Department of Radiology, Kishiwada Tokushukai Hospital, 4-27-1, Kamori-cho, Kishiwada-shi 596-8522, Japan.
2 Department of Internal Medicine, Kishiwada Tokushukai Hospital, Kishiwada-shi 596-8522, Japan.
3 Department of Radiology, Wakayama Medical University, 811-1, Kimiidera, Wakayama-shi 641-8510, Japan.



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  		Fig. 1A. —77-year-old woman with duodenal varices. Contrast-enhanced CT scan obtained before balloon-occluded retrograde transvenous obliteration (BRTO) shows duodenal varices (arrow) and dilated draining veins.

 


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  		Fig. 1B. —77-year-old woman with duodenal varices. Angiogram shows duodenal varices and dilated right ovarian vein. Balloon catheter was inserted into right ovarian vein via right femoral vein. During balloon occlusion, 5% ethanolamine oleate with iopamidol (20 mL) was infused through microcatheter (arrow).

 


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  		Fig. 1C. —77-year-old woman with duodenal varices. Contrast-enhanced CT scan obtained morning after BRTO shows complete thrombosis of varices and draining veins.

 


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  		Fig. 1D. —77-year-old woman with duodenal varices. Endoscopic image obtained 1 week after BRTO shows large varix with redness in second portion of duodenum.

 


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  		Fig. 1E. —77-year-old woman with duodenal varices. Endoscopic image obtained 4 months after BRTO shows size of varices is markedly reduced.

 

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