[Duodenal varices treated successfully by percutaneous transhepatic obliteration: report of a case]

A 73-year-old female with bleeding from duodenal varices treated by percutaneous transhepatic obliteration (PTO) was reported. She was admitted to our hospital because of tarry stool and general malaise. Gastroduodenoscopy revealed tortous elevations in the descending part of the duodenum, and observed intermittent bleeding. Percutaneous transhepatic portography (PTP) was carried out. PTP revealed duodenal varices supplied via the inferior pancreaticoduodenal vein and drained to the inferior vena cava, and continuously obliterated by gelfoam. Duodenal varices disappeared after obliteration and we observed no recurrence of varices for a year endoscopically. In general, it is accepted that the causes of the upper gastrointestinal bleeding secondary to portal hypertension are esophagogastric varices, hemorrhagic gastritis, gastro-duodenal ulcer, and so on. However, we must keep in mind the case with duodenal varices in which bleedings are of unknown origin. We also reviewed duodenal varices reported in Japanese literature from 1968 to 1989.