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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Related Experiment Video

Updated: Mar 1, 2026

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
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Gastroesophageal Variceal Bleeding Successfully Controlled by Partial Splenic Embolization.

Takayuki Kogure1, Jun Inoue1, Eiji Kakazu1

  • 1Division of Gastroenterology1, Tohoku University Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|June 2, 2017
PubMed
Summary

Partial splenic embolization effectively controlled refractory gastroesophageal varices and portal hypertension in a hepatocellular carcinoma patient. This interventional radiology technique offered a long-term solution for variceal bleeding management.

Keywords:
gastroesophageal varicespartial splenic embolization

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Area of Science:

  • Interventional Radiology
  • Hepatology
  • Gastroenterology

Background:

  • Gastroesophageal varices are a common complication of portal hypertension, often associated with hepatocellular carcinoma.
  • Endoscopic injection sclerotherapy (EIS) is a standard treatment, but can be refractory in some cases.

Observation:

  • A 53-year-old male with hepatocellular carcinoma had recurrent variceal bleeding despite six EIS sessions.
  • Following hepatic resection, the patient developed massive splenomegaly, indicating persistent portal hypertension.

Findings:

  • Partial splenic embolization (PSE) was performed to reduce portal pressure.
  • This intervention successfully controlled gastroesophageal varices and prevented bleeding for 13 years.

Implications:

  • Partial splenic embolization is a viable alternative for managing refractory gastroesophageal varices and portal hypertension.
  • PSE may improve outcomes in patients with hepatocellular carcinoma and complications of portal hypertension.