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Title of Journal: Cardiovasc Intervent Radiol

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Abbravation: CardioVascular and Interventional Radiology

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Springer-Verlag

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DOI

10.1016/0009-2614(95)00643-i

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1432-086X

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Management of Gastric Varices

Authors: Akio Matsumoto
Publish Date: 2011/08/11
Volume: 35, Issue: 5, Pages: 1253-1253
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Abstract

I recently read with great interest the article by d’Othee et al The authors treated gastric varices in the patient with partial splenic and portal thrombs by balloonoccluded retrograde transvenous obliteration BRTO 1 The patient had remarkable splenomegaly and thrombocytopenia so congestion of the splenic vein seemed to have existed before BRTO Worsening of esophageal varices after BRTO is thought to be due to the increase of blood flow in the branch of splenic vein eg left gastric vein BRTO followed by partial splenic embolization 2 3 might prevent the rupture of esophageal varices and performance of transjugular intrahepatic portosystemic shunting by the suppression of the increase of the blood flow in splenic vein The efficacy of BRTO in patients with an advanced liver disease eg ChildPugh classification C is unclear 4 The present patient had a very small liver What was the patient’s ChildPugh score Performance of Doppler ultrasonography could reveal the change of blood flow in splenic vein before and after BRTO as well as after ligation of esophageal varices

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