Recent advances in chemotherapy and radiotherapy have led to an increase in the number of long-term survivors of pancreatic cancer. However, this has also increased the number of patients suffering from ectopic varices and bleeding owing to left-sided portal hypertension and thrombocytopenia caused by splenomegaly after pancreaticoduodenectomy combined with resection of the splenic vein. A 65-year-old woman with varices of the elevated jejunum due to left sided portal hypertension after pancreaticoduodenectomy had repeated melena, which started about 1 year before admission. We describe the first reported case of percutaneous transsplenic venous embolization using metallic coils, which successfully achieved hemostasis of refractory bleeding from the elevated jejunal varices after pancreaticoduodenectomy.
Keywords: CT, computed tomography; CTV, computed tomography during venography; EO, ethanolamine oleate; Elevated jejunal varices; LSPH, left-sided portal hypertension; Left-sided portal hypertension; PD, pancreaticoduodenectomy; PSE, partial splenic artery embolization; PV, portal vein; Pancreaticoduodenectomy; Percutaneous transsplenic venous embolization; SMV, superior mesenteric vein; STS, sodium tetradecyl sulfate; SV, splenic vein.
© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.