Percutaneous Transmesenteric Access for the Embolization of Bleeding Jejunal Varices at the Hepaticojejunostomy Site:...

A 78-year-old man with a history of pancreaticoduodenectomy for ampullary cancer presented with bleeding jejunal varices at the hepaticojejunostomy site. Computed tomography revealed long-segment occlusion of the proximal superior mesenteric vein. Recanalization and stenting of the occluded vein were considered difficult. The varices were continuous with a jejunal vein, which was clearly visible and compressible on ultrasonography. The jejunal vein was percutaneously punctured, and the varices were embolized using 5% ethanolamine oleate via a 6-F introducer. Hemostasis was achieved using ultrasound-guided compression. No bleeding complications were observed. Thus, percutaneous transmesenteric access is a viable option for the embolization of jejunal varices at the hepaticojejunostomy site.