Endoscopic ultrasound-guided coil deployment with sclerotherapy for gastric varices.
Kenji NakamuraTakeshi OkamotoYasutoshi ShiratoriKatsuyuki FukudaPublished in: Clinical journal of gastroenterology (2020)
We present a case of gastric varices (GV) in the fundus treated by endoscopic ultrasound (EUS)-guided coil deployment with sclerotherapy. A 46-year-old man with a previous history of fatty liver and obesity presented to the emergency department with abdominal pain. Contrast computed tomography (CT) showed chronic liver disease, splenomegaly, and GV. Esophagogastroduodenoscopy (EGD) showed GV in the fundus. Follow-up EGD 6 months later revealed an increase in GV diameter to over 20 mm. Balloon-occluded retrograde transvenous obliteration appeared difficult due to the small caliber of the gastrorenal shunt observed on contrast CT. We performed EUS-guided coil deployment with sclerotherapy. The coil was deployed using a 19-gauge needle under EUS and fluoroscopic guidance. Next, 5% ethanolamine oleate with contrast medium was injected into GV using a 22-gauge needle. GV was reduced without complications, and no GV growth or hemorrhage was observed during 8 months of follow-up.
Keyphrases
- ultrasound guided
- fine needle aspiration
- computed tomography
- contrast enhanced
- emergency department
- magnetic resonance
- magnetic resonance imaging
- positron emission tomography
- dual energy
- image quality
- abdominal pain
- metabolic syndrome
- diabetic retinopathy
- type diabetes
- insulin resistance
- pulmonary artery
- risk factors
- adipose tissue
- single cell
- pulmonary arterial hypertension
- adverse drug