±¸¼Ò¹Ì(Koo So-My) - Soonchunhyang University Hospital Department of Gastroenterology Institute for Digestive Research and Digestive Disease Center
Á¤½Â¿ø(Jeong Soung-Won) - Soonchunhyang University Hospital Digestive Disease Center Institute for Digestive Research
ÀåÀ翵(Jang Jae-Young) - Soonchunhyang University Hospital Digestive Disease Center Institute for Digestive Research
ÀÌÅÂÈñ(Lee Tae-Hee) - Soonchunhyang University Hospital Digestive Disease Center Institute for Digestive Research
Àü¼º¶õ(Jeon Seong-Ran) - Soonchunhyang University Hospital Institute for Digestive Research
±èÇö°Ç(Kim Hyun-Gun) - Soonchunhyang University Hospital Institute for Digestive Research
±èÁø¿À(Kim Jin-Oh) - Soonchunhyang University Hospital Institute for Digestive Research
±è¿ëÀç(Kim Yong-Jae) - Soonchunhyang University Hospital Department of Radiology
Abstract
A 52-yr-old male with alcoholic liver cirrhosis was hospitalized for hematochezia. He had undergone small-bowel resection due to trauma 15 yr previously. Esophagogastroduodenoscopy showed grade 1 esophageal varices without bleeding. No bleeding lesion was seen on colonoscopy, but capsule endoscopy showed suspicious bleeding from angiodysplasia in the small bowel. After 2 weeks of conservative treatment, the hematochezia stopped. However, 1 week later, the patient was re-admitted with hematochezia and a hemoglobin level of 5.5 g/dL. Capsule endoscopy was performed again and showed active bleeding in the mid-jejunum. Abdominal computed tomography revealed a varix in the jejunal branch of the superior mesenteric vein. A direct portogram performed via the transhepatic route showed portosystemic collaterals at the distal jejunum. The patient underwent coil embolization of the superior mesenteric vein just above the portosystemic collaterals and was subsequently discharged without re-bleeding. At 8 months after discharge, his condition has remained stable, without further bleeding episodes.
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Hematochezia, Capsule Endoscopy, Abdominal Computed Tomography, Jejunal Varices, Embolization
KMID :
0191120120270030321
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À¯È¿¼º°á°ú(Recomendation)
Capsule endoscopy was performed and showed active bleeding in the mid-jejunum.