Open AccessEndovascular interventions for traumatic portal venous hemorrhage complicated by portal hypertension
Author(s) -
Dinesh Kumar Sundarakumar,
Crysela Mirta Smith,
Jorge E. Lopera,
Matthew J. Kogut,
Rajeev Suri
Publication year - 2013
Publication title -
world journal of radiology
Language(s) - English
Resource type - Journals
ISSN - 1949-8470
DOI - 10.4329/wjr.v5.i10.381
Subject(s) - medicine , portal hypertension , transjugular intrahepatic portosystemic shunt , portography , blunt , shunt (medical) , varix , radiology , portal vein , surgery , ligation , portosystemic shunt , blunt trauma , ligature , varices , cirrhosis
Life-threatening hemorrhage rarely occurs from the portal vein following blunt hepatic trauma. Traditionally, severe portal bleeding in this setting has been controlled by surgical techniques such as packing, ligation, and venorrhaphy. The presence of portal hypertension could potentially increase the amount of hemorrhage in the setting of blunt portal vein trauma making it more difficult to control. This case series describes the use of indirect carbon dioxide portography to identify portal hemorrhage. Furthermore, these cases illustrate attempted endovascular treatment utilizing a transjugular intrahepatic portosystemic shunt in one scenario and transmesocaval shunt coiling of a jejunal varix in the other.