J Korean Soc Radiol.  2014 Mar;70(3):201-204. 10.3348/jksr.2014.70.3.201.

Gastric Variceal Rebleeding by Aberrant Left Gastric Vein after Transjugular Intrahepatic Portosystemic Shunt: A Case Report

• Lee JH
• Kim YH
• Kang WR
• Lee YH

• KMID: 1839432
• DOI: http://doi.org/10.3348/jksr.2014.70.3.201

Abstract

The aberrant left gastric vein can be a rare cause of gastric variceal bleeding in portal hypertensive patients. Careful examination of vascular anatomy on CT scan and simultaneous embolization of the aberrant left gastric vein during the tranjugular intrahepatic portosystemic shunt are necessary to prevent gastric variceal rebleeding. Herein, we report a case of gastric variceal rebleeding by the aberrant left gastric vein after transjugular intrahepatic portosystemic shunt, which was retrospectively diagnosed by CT scan and portogram, and successfully treated by coil embolization.

MeSH Terms

Embolization, Therapeutic
Esophageal and Gastric Varices
Humans
Portasystemic Shunt, Surgical*
Retrospective Studies
Tomography, X-Ray Computed
Veins*

Figure

• 

  Fig. 1 A 63-year-old male with massive hematemesis. A. Abdominal contrast enhanced CT scan reveals the aberrant left gastric vein (arrow). B. Portogram after TIPS shows gastric variceal flow fed by the left gastric and posterior gastric veins. C. Portogram obtained 5 days after TIPS and variceal embolization reveals residual variceal flow via the aberrant left gastric vein (arrow). D. Portogram after embolization of the aberrant left gastric artery shows complete exclusion of the residual gastric variceal flow. Note.-TIPS = transjugular intrahepatic portosystemic shunt

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