Recurrent Varices after Transabdominal Esophageal Transection

Tetsuo Nagata, Hiroshi Ashida, Kazumitsu Takagi, Akihiko Nishioka, Naoki Hashimoto, Yoshinao Kotoura, Joji Utsunomiya

Second Department of Surgery, Hyogo College of Medicine

We report a 57-year-old man with recurrent esophagogastric varices who underwent transabdominal esophageal transection 7 years and 4 months earlier. Abdominal angiographic study revealed that the posterior gastric artery was the main feeder for the recurrent varices. Moreover, there were no collaterals from the portal vein system to the recurrent varices. A huge gastrorenal systemic shunt was observed, but it had no linkage with the recurrent gastric varices. The regional hyperdynamic state in the upper gastric wall might have caused the recurrent varices in this case. The gastrorenal shunt had no effect on decompression of the recurrent varices. The recurrent varices were eradicated by transarterial embolization of the posterior gastric artery and one another following endoscopic sclerotherapy.

Key words
recurrent esopahgogastic varices, posterior gastric artery, transarterial embolization

Reprint requests
Hiroshi Ashida Second Department of Surgery, Hyogo College of Medicine
1-1 Mukogawa-cho, Nishinomiya, 663 JAPAN

Accepted
April 17, 1991

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