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Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography
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Shin Haba
, Kazuo Hara, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Akira Miyano, Daiki Fumihara, Moaz Elshair - Clin Endosc 2022;55(3):458-462. Published online November 30, 2021
- DOI: https://doi.org/10.5946/ce.2021.114
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Abstract
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ePub - Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to prevent bleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old male patient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle, and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coils were placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumen cannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next day revealed no complications.
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Citations
Citations to this article as recorded by
- Endoscopic ultrasound-guided glue embolization to prevent hemorrhage after accidental tract formation to the portal venous system during hepaticogastrostomy
Chloë Hanssens, Elisabeth Dhondt, Pieter Hindryckx
Endoscopy.2026; 58(S 01): E318. CrossRef - An unusual case of high gastrointestinal bleeding after Whipple surgery
E Dubois, R Geelen
Acta Gastro Enterologica Belgica.2024; 87(3): 430. CrossRef
- Endoscopic ultrasound-guided glue embolization to prevent hemorrhage after accidental tract formation to the portal venous system during hepaticogastrostomy
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- A Case of Gastric Adenocarcinoma Arising from Ectopic Pancreas showing Gastric Outlet Obstruction
- Suk Hyun Jung, M.D., Hang Lak Lee, M.D., Seung Sam Paik, M.D.*, Hulin Han, M.D.*, Tae Kyung Ha, M.D.†, Byeong Bae Park, M.D., Chang Ryeol Choi, M.D. and Soon Young Song, M.D.‡
- Korean J Gastrointest Endosc 2011;42(6):373-377. Published online June 17, 2011
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Abstract
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- An ectopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We report herein a rare case of malignant transformation of ectopic pancreas in the stomach, associated with gastric outlet obstruction. A 69-year-old woman was admitted to our hospital, complaining of vomiting. Esophagogastroduodenoscopy revealed an encircling submucosal tumor-like lesion on the prepyloric antrum showing outlet obstruction. Abdominal CT showed an enhancing mass on the antrum and PET CT showed hypermetabolic wall thickening. So we performed a subtotal gastrectomy. Surgical specimens showed a moderately differentiated ductal adenocarcinoma, and the tumor cells were strongly positive for cytokeratin 7. The tumor was located close to the ectopic pancreas tissue. The tumor showed subserosal and omental invasion. There was one lymph node metastasis and no distant metastasis. The patient is being followed up in the outpatient department.
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