Journal List > J Korean Soc Radiol > v.70(3) > 1087369

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Lee, Kim, Kang, and Lee: Gastric Variceal Rebleeding by Aberrant Left Gastric Vein after Transjugular Intrahepatic Portosystemic Shunt: A Case Report
Cardiovascular Radiology

Journal of the Korean Society of Radiology 2014; 70(3): 201-204.

Published online: 12 March 2014

DOI: https://doi.org/10.3348/jksr.2014.70.3.201

Gastric Variceal Rebleeding by Aberrant Left Gastric Vein after Transjugular Intrahepatic Portosystemic Shunt: A Case Report

Jong Hun Lee, MD1, Young Hwan Kim, MD2, Woong Rae Kang, MD1, Young Hwan Lee, MD1

1Department of Radiology, Catholic University of Daegu College of Medicine, Daegu, Korea.

2Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea.

Corresponding author: Young Hwan Kim, MD. Department of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea. Tel. 82-53-250-7770, Fax. 82-53-250-7766, yhkim68@dsmc.or.kr

Received 15 October 2013       Accepted 21 January 2014

Copyright © 2014 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aberrant left gastric vein can be a rare cause of gastric variceal bleeding in portal hypertensive patients. Careful examination of vascular anatomy on CT scan and simultaneous embolization of the aberrant left gastric vein during the tranjugular intrahepatic portosystemic shunt are necessary to prevent gastric variceal rebleeding. Herein, we report a case of gastric variceal rebleeding by the aberrant left gastric vein after transjugular intrahepatic portosystemic shunt, which was retrospectively diagnosed by CT scan and portogram, and successfully treated by coil embolization.

Keywords: Gastric Varix, Aberrant Left Gastric Vein, Transjugular Intrahepatic Portosystemic Shunt, Embolization

Figures and Tables

Fig. 1
A 63-year-old male with massive hematemesis.
A. Abdominal contrast enhanced CT scan reveals the aberrant left gastric vein (arrow).
B. Portogram after TIPS shows gastric variceal flow fed by the left gastric and posterior gastric veins.
C. Portogram obtained 5 days after TIPS and variceal embolization reveals residual variceal flow via the aberrant left gastric vein (arrow).
D. Portogram after embolization of the aberrant left gastric artery shows complete exclusion of the residual gastric variceal flow.
Note.-TIPS = transjugular intrahepatic portosystemic shunt
jksr-70-201-g001

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