Percutaneous transhepatic sclerotherapy for bleeding ileal varices associated with portal hypertension and previous abdominal surgery

A 75-year-old man with portal hypertension was referred to our institution because he suddenly began to pass a large amount of tarry stool. Arterial portography and computed tomography (CT) during arterial portography via the superior mesenteric artery, using a unified 64-slice multidetector row CT and angiography system, revealed bleeding ileal varices. The varices were supplied blood by a single ileal vein and drained by dilated veins in the abdominal wall. The bleeding was successfully arrested by performing percutaneous transhepatic sclerotherapy with 12 ml of 5% ethanolamine oleate. The blood flow to the varices was controlled by balloon occlusion, and microcoils were inserted into the varices and supplying vein. No complications or rebleeding occurred during the 13-month follow-up period, and CT images obtained during follow-up showed that the varices had disappeared.