Direct percutaneous access to an omental vein for embolization of Roux-en-Y limb varices in a child

Yasuyuki Onishi; Hironori Shimizu; Eri Ogawa; Tatsuya Okamoto; Yuji Nakamoto

doi:10.1016/j.radcr.2022.01.046

Direct percutaneous access to an omental vein for embolization of Roux-en-Y limb varices in a child

Radiol Case Rep. 2022 Feb 3;17(4):1143-1147. doi: 10.1016/j.radcr.2022.01.046. eCollection 2022 Apr.

Authors

Yasuyuki Onishi¹, Hironori Shimizu¹, Eri Ogawa², Tatsuya Okamoto², Yuji Nakamoto¹

Affiliations

¹ Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, Japan.
² Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Abstract

An 11-year-old boy with a history of hepatoblastoma treated with chemotherapy, radiation therapy, and liver transplantation presented with bleeding from Roux-en-Y limb varices. The transhepatic approach for portal intervention posed a risk of liver graft injury. An omental vein that was dilated as a collateral vein due to portal hypertension was found and compressible under ultrasound. The omental vein was percutaneously punctured, and the varices were embolized through a jejunal vein. No complication occurred. Direct percutaneous access to the portal venous system is a useful technique for portal embolization.

Keywords: Direct percutaneous access; Embolization; Pediatrics; Roux-en-Y limb varices.

Publication types

Case Reports