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Chalermrat Bunchorntavakul 1 Article
Endoscopic Ultrasound-Guided Vascular Therapy for Portoduodenal Fistula
Tanyaporn Chantarojanasiri, Apichet Sirinawasatien, Chalermrat Bunchorntavakul, Aroon Siripun, Sa-ard Treepongkaruna, Thawee Ratanachu-ek
Clin Endosc 2020;53(6):750-753.   Published online February 13, 2020
AbstractAbstract PDFPubReaderePub
Portoenteric fistula is a rare cause of massive upper gastrointestinal bleeding. Most cases can be treated with radiointervention or surgery, but portoenteric fistula is associated with a high mortality. We reported a case of intermittent massive upper gastrointestinal bleeding in a 33-year-old man with cholangiocarcinoma who underwent surgical resection followed by chemoradiation. A portoduodenal fistula due to chronic duodenal ulceration was identified. The bleeding was successfully controlled by endoscopic ultrasound-guided coil placement through the duodenal bulb using the anchoring technique. Follow-up endoscopy and computed tomography scan showed multiple coil placements between a part of the portal vein and the duodenal bulb without any evidence of portal vein thrombosis. There were no complications, and bleeding did not recur during the 8-month follow-up period.


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