山口医学

山口大学医学会

PISSN : 0513-1731
NCID : AN00243156

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Yano Kanae Hirano Atsuyoshi Oshita Satoshi Harada Katsunori Tsuchiya Masako Kimura Teruaki Kato Akira Setoguchi Mihoko Yamashita Satoyoshi Okita Kiwamu
PP. 115 - 120
Kubo Hidefumi Nagaoka Chisato Tada Kosuke Miyahara Makoto Hasegawa Hiroyasu Kondo Satoshi
PP. 121 - 127
Kubo Hidefumi Nagaoka Chisato Tada Kosuke Miyahara Makoto Hasegawa Hiroyasu Yamashita Yoshimi
PP. 129 - 137
PP. 139 - 143
Duodenal varices(DV)are the most common of ectopic varices. Although bleeding from DV is rare, it is difficult to control bleeding and sometimes fatal. We have encountered four clinical cases of ruptured DV. Case 1:A man in his 80s presented with a history of partial gastrectomy with Billroth-II reconstruction and LC due to chronic hepatitis C. We performed single-balloon endoscopy and injected 67% N-butyl-2-cyanoacrylate(NBCA)for DV on the afferent loop with red plug. Case 2:A woman in her 40s with primary biliary cirrhosis complained of tarry stool and anemia. We performed endoscopic injection sclerotherapy(EIS)with 67% NBCA for spurting bleeding point in duodenum. Case 3:A man in his 50s with liver cirrhosis(LC)due to chronic hepatitis B complained of tarry stool. We performed endoscopic variceal ligation(EVL)and balloon-occluded retrograde transvenous obliteration(B-RTO)for DV. Case 4:A man in his 60s with alcoholic LC complained of tarry stool. We performed EIS with 67% NBCA for DV. We added EVL, clipping, and argon plasma coagulation after EIS to control bleeding. To control bleeding was achieved in all cases.
PP. 145 - 152
Fukamitsu Gaku Noshima Shinji Sugiyama Nozomu Kaneda Yoshikazu Suto Ryuichiro Kamei Toshiaki
PP. 153 - 157