Analysis of laparoscopic repair of traumatic bladder neck obliteration / 中华泌尿外科杂志

There are few reports on laparoscopic repair of traumatic atresia of bladder neck. In this study, three patients with traumatic atresia of bladder neck were repaired by laparoscopic surgery, and the surgery was successfully completed. During postoperative follow-up, the patients had smooth urination, no urinary incontinence and sexual function damage, and laparoscopic surgery was effective in repairing traumatic atresia of bladder neck.

Endodoncia guiada Para el manejo de Canales Obliterados, Reporte de Caso / Guided Endodontic Treatment for the Management of Obliterated Pulp Canals. A Case Report

RESUMEN: El objetivo: de este reporte es presentar el tratamiento endodóntico de un diente ante-rior con obliteración del canal radicular, con la ayuda de la endodoncia guiada. Paciente masculino sin antecedentes médicos relevante, y en tratamiento ortodóntico. Diente 2.1 con historia de traumatismo dento-alveaolar y presencia de dolor a la percusión. En la TCHC se observa obliteración total del canal radicular en el tercio cervical y medio y un área de radiolucidez apical. Diagnóstico: Periodontitis apical Sintomática. Tratamiento: Terapia de canal No vital, con planificación virtual y guía endodóntica. Se utilizó el programa de acceso gratuito, Bluesky Plan®, para la planifica-ción digital de la guía endodóntica. El tratamiento se realizó en dos citas. Conclusión: el uso de tecnología para la resolución de casos de alta complejidad en endodoncia, podría ayudar a mejorar el pronóstico de estos dientes y ser una alternativa más segura para reducir la posibilidad de perforación y preservar estructura dental.

ABSTRACT: The aim: of this case report is to present the endodontic treatment of an anterior tooth with an obliterated pulp canal, with the help of guided endodontics. Male patient with no relevant medical history, currently with orthodontic treatment. Tooth 2.1 had a history of dental trauma and presented tenderness to percussion. The CBCT exam showed a completely obliterated root canal in the cervical and middle third, and apical radiolucency. Diagnosis: Symptomatic Apical Periodontitis. Treatment: Root canal treatment with virtual planning and endodontic guide. Bluesky Plan® free access program was used for the digital planning of the endodontic guide. The treatment: was made in two sessions. Conclusion: the use of technology for the resolution of high complexity cases in endodontics could help improve the prognosis of these teeth and be a safer alternative to reduce the possibility of perforation and preserve more tooth structure.

O Mapa de Ausências e Apagamentos em A Rua dos Crocodilos, de Bruno Schulz / The Map of Absences and Obliterations in Bruno Schulz's The Street Of Crocodiles / El Mapa de Ausencias y Eliminaciones en La Rua de Los Crocodilos, de Bruno Schulz

Este trabalho procura colocar em destaque, por meio da narrativa do escritor polonês Bruno Schulz, um operador possível para o enlace entre psicanálise e literatura: o texto (o romance literário ou uma vida narrada em análise) como resultante da impossibilidade de representar o real. A leitura de Schulz, guiada pela bússola da teoria psicanalítica de Freud e Lacan, permite com que se acentue o que chamamos de "mapa de ausências e apagamentos", elemento presente e transversalizador na compilação dos quinze contos que integram A rua dos Crocodilos. Esse mapa traça as linhas de um território no qual é possível realçar as reverberações do conceito de estranho de Freud e, com ele, refletir sobre os efeitos de leitura produzidos pela obra do escritor polonês. (AU)

This paper aims to highlight, trough the narrative of the polish writer Bruno Schulz, a possible operator for the link between psychoanalysis and literature: text (literary novel or a life narrated in analysis) as the result of the impossibility to represent real. The reading of Schulz with the guidelines from Freud's and Lacan's psychoanalytic theories let us examine what we have called "map of absences and obliterations" in the compilation of fifteen short stories The street of croocodiles. This map traces the lines of a territory in which is possible to highlight the reverberations of Freud's concept of strange, and enable us to reflect upon the effects of the reading Schulz's works. (AU)

El presente trabajo forma parte de una investigación más amplia, inspirada en la vida y obra de Bruno Schulz, que se propone pensar el proyecto artístico y literario del escritor norteamericano Jonathan Safran Foer, llamado Tree of codes (2010). En este artículo, partiendo de la obra de Schulz La calle de los cocodrilos, nos dedicamos a reflexionar sobre la relación entre el psicoanálisis y lo que denominamos "mapa de ausencias y eliminaciones", presente en esa compilación de 15 cuentos del escritor polaco. Esa relación nos permitirá establecer un operador posible para el enlace entre psicoanálisis y literatura: el texto (la novela literaria o una vida narrada en análisis) como resultante de la imposibilidad de representar lo real. (AU)

Cardiac magnetic resonance in tropical endomyocardial fibrosis

Background: Endomyocardial fibrosis has varied presentatation and difficult to diagnose. Aim to elucidate the role of Cardiac Magnetic Resonance (CMR) imaging in the evaluation of Endomyocardial Fibrosis (EMF) and to devise diagnostic criteria for the disease.Methods: Retrospective analysis of cases of restrictive cardiomyopathy referred for Magnetic resonance imaging over a period of 5 years. All patients underwent 1.5 T CMR imaging (Magnetom Avanto, Siemens, Germany) with standard cardiomyopathy protocol. Criteria for diagnosis of RCM included normal sized ventricles, normal/reduced systolic function, uni-/bi-atrial enlargement, normal pericardium and absent septal bounce. Cases diagnosed as EMF on CMR were included in this study. Statistical analysis performed using SPSS software.Results: EMF was diagnosed in 20 patients (31%) [12 males; age 39±18 years]. Ten patients had Right Centricular (RV) EMF, 3 had Left Ventricular (LV) EMF, while 7 had bi-ventricular EMF. Oedema indicating ongoing inflammation was seen in 4 (20%) cases. Apical thrombus was seen in 8(40%) cases and was present in 35% cases of RV and 20% cases of LV involvement. Subendocardial delayed enhancement was always present in the involved ventricle. The RV apex was obliterated in 100% of patients with RV EMF, while LV apex was similarly obliterated in 66% cases with LV disease. Mild-moderate pericardial effusion was observed in 8 patients. On the basis of CMR findings, the disease was classified as early necrotic phase in 1, thrombotic necrotic in 4 and late fibrotic phase in 13 and of different stages in ventricles in 2 cases.Conclusions: EMF was the commonest cause of RCM in this series. Major diagnostic criteria of EMF on CMR include subendocardial delayed enhancement and apical obliteration. Oedema and thrombus are variable findings, depending on disease severity.

Hearing Outcome Following Canal Wall Down Mastoidectomy With And Without Mastoid Cavity Obliteration And Round Window Shielding- A Comparative Observational Study

INTRODUCTION- The accurate diagnosis of disease tissue is elementary to the precise diagnosis and proper management of central nervous system lesions. Although histopathology is gold standard, in neurosurgical practice intraoperative cytological diagnosis is now well established and emerge as a dependable standalone diagnostic tool. The rapidity at which sufficient preliminary information for optimal surgery is provided to neurosurgeons, help him take crucial decision regarding patients management. Overall soft nature of CNS lesions ,best suited for smear cytology, which in fact is the major restriction while performing intraoperative Frozen section consultation. So the present study was done to assess the utility of squash cytology in intraoperative diagnosis of CNS lesions. MATERIALAND METHODS-In this prospective study 142 patients with clinical diagnosis of CNS lesions were studied. Patients clinical and radio imaging findings were taken into account while evaluating squash smear preparation. Squash diagnosis was latter correlated with final histopathological diagnosis . RESULTS– Out of 142 cases, cytological diagnosis was offered in 136 cases. In 6 cases no opinion was possible on cytology. Cyto-histological correlation was seen in 127 out of 136 cases, 9 cases remained discordant. Thus overall diagnostic accuracy of squash cytology in intraoperative diagnosis of CNS lesions in our study was 93.38%. CONCLUSION- Intraoperative squash cytology is easy ,rapid, reliable and cost-effective technique for neurosurgical consultation with fairly high accuracy. Knowledge of clinicoradiological details help to further improve the diagnostic accuracy

Experience and early results of radiofrequency ablation therapy for varicose veins / 中华普通外科杂志

Objective To evaluate the experience and early results of radiofrequency ablation (RFA) therapy for varicose veins.Methods In this study 380 extremities of 356 patients undergoing RFA therapy with RFA catheter for varicose veins from Nov 2015 to Sep 2017 in Beijing Tsinghua Changgung Hospital were retrospectively reviewed.Each patient was scheduled to follow up at 1,6 and 12 months respectively.Results Technical success were achieved in all cases.Obliteration rate was 99.0％ in 1 month,97.9％ in 6 months and 97.1％ in 12 months after the RFA therapy.Conclusions RFA therapy for varicose veins is safe and effective and achieves good early result.Intraoperative ultrasound examination and endovascular technique is important for a successful RFA procedure.

Prenatal ultrasonographic diagnosis of the fetal ductus venosus abormalities / 中华超声影像学杂志

Objective To explore the prenatal ultrasound image features and clinical significance of fetal ductus venosus abormalities . Methods Fifteen fetuses with ductus venosus abormalities diagnosed by prenatal ultrasonography at Peking University T hird Hospital were retrospective review . T he prenatal findings ,umbilical shunting type ,perinatal outcomes ,and autopsy reports were analyzed . Results Fourteen fetuses were found with absence of ductus venosus . In 6 fetuses the umbilical vein connected to the portal vein ,5 fetuses the umbilical vein connected to the inferior vena cava and 3 fetuses the umbilical vein connected to the right atrium . T he remaining 1 fetus was found obliteration of ductus venosus . Absence of ductus venous showed no normal ductus venous and the umbilical vein almost always drained directly into portal vein ,inferior vena cava or right atrium . Obliteration of ductus venous showed normal ductus venous was replaced by a tiny echogenic string without blood flow . T hree cases had intracardiac and extracardiac abnormalities ; 4 cases had extracardiac abnormalities only ; 8 of these ,ductus venosus abormality were isolated . T wo cases had trisomy 21 syndrome . Four patients underwent legal termination of pregnancy ; 2 were intrauterine fetal death ; and 8 carried to term wit normal outcome ; the remaining one underwent operation due to extracardiac abnormality and postoperative course was uneventful . Conclusions Prenatal ultrasound can be used to diagnose fetal ductus venosus abormalities . Hemodynamic depends on umbilical venous drainage site and diameter . T he prognosis for this group of anomalies depends on the chromosomal abnormalities and additional findings . Chromosome and ultrasonic monitoring are suggested for following pregnancy .

Balloon-Occluded Retrograde Transvenous Obliteration versus Transjugular Intrahepatic Portosystemic Shunt for the Management of Gastric Variceal Bleeding

BACKGROUND/AIMS: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. METHODS: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. RESULTS: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (log-rank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. CONCLUSIONS: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Gastric Varices: The Role of Intra-Procedural Cone-Beam Computed Tomography

OBJECTIVE: To investigate the technical and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GV) and to evaluate the role of intra-procedural cone-beam computed tomography (CBCT) performed during PARTO to confirm its technical success. MATERIALS AND METHODS: From January 2016 to December 2016, 17 patients with GV who had undergone PARTO were retrospectively evaluated. When the proximal part of the afferent vein was identified on a fluoroscopy, non-contrast CBCT images were obtained. In patients with incomplete embolization of GV, an additional injection of gelatin sponges was performed. Follow-up data from contrast-enhanced CT and upper intestinal endoscopy, as well as clinical and laboratory data were collected. RESULTS: Plug-assisted retrograde transvenous obliteration procedures were technically successful in all 17 patients. Complete embolization of GV was detected on CBCT images in 15 patients; whereas, incomplete embolization was detected in two. Complete embolization of GV was then achieved after an additional injection of gelatin sponges in these two patients as demonstrated on the 2nd CBCT image. The mean follow-up period after PARTO was 193 days (range, 73–383 days). A follow-up CT obtained 2–4 months after PARTO demonstrated marked shrinkage or complete obliteration of GV and portosystemic shunts in all 17 patients. There were no cases of variceal bleeding during the follow-up. CONCLUSION: Plug-assisted retrograde transvenous obliteration is technically and clinically effective for the treatment of GV. In addition, intra-procedural CBCT can be an adjunct tool to fluoroscopy, because it can provide an immediate and accurate evaluation of the technical success of PARTO.

Prevention and management of gastroesophageal varices

Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published. The present article reviews published articles and practice guidelines to present the most optimal management of patients with gastroesophageal varices.

Endovenous laser obliteration versus traditional surgical ligation for the treatment of varicosis of lower extremity: a comparative study / 介入放射学杂志

Objective To compare the effectiveness and the influence on life quality of endovenous laser obliteration with those of traditional surgical ligation in treating varicosis of lower extremity.Methods By using numerical random grouping method,40 patients with varicosis of lower extremity were divided into traditional surgical ligation group (high ligation plus stripping,traditional group,n=20) and endovenous laser obliteration group (laser group,n=20).The curative effect and complications were compared between the two groups.According to the brief health survey (SF-36) scale,the influences of the two treatments on the life quality were evaluated.Results During the follow-up period,the differences in the curative effect and complications between two groups were not significant (P＞0.05).The life quality assessed by SF-36 scores in the laser group was better than that in the traditional group,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the treatment of varicosis of lower extremity,endovenous laser obliteration is safe and effective,it carries less influence on the patient's life quality when compared with traditional surgical ligation therapy.

Concomitant Valve Surgery and Long Distal Bypass for Severe Mitral Regurgitation and Critical Limb Ischemia / 日本心臓血管外科学会雑誌

<p>A 75-year-old man with underlying arteriosclerosis obliterans presented with acute heart failure secondary to rest pain of the right lower extremity. Echocardiogram showed severe mitral regurgitation, moderate tricuspid regurgitation and a low cardiac function (ejection fraction : 27%). Right toe gangrene developed in association with continuous acute heart failure. He underwent mitral valve replacement, tricuspid annuloplasty, right common femoral artery-posterior tibial artery bypass and amputation of the right toes in single-stage surgery. There were no major complications during his hospital stay. After surgery, his symptoms significantly improved.</p>

Moxibustion at Geshu (BL 17) for diabetic limb arterial obliteration at early stage / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy differences between moxibustion at Geshu (BL 17) and oral administration of cilostazol on diabetic limb arterial obliteration (DLAO) at early stage as well as the impacts on hemorheology and arterial inner dimension of lower extremity.</p><p><b>METHODS</b>Seventy patients of DLAO at early stage were randomly divided into an observation group and a control group, 35 cases in each one. The two groups were treated with regular treatment of blood glucose and blood lipid. The patients in the control group was treated with oral administration of cilostazol, 50 mg, twice a day; the patients in the observation group were treated with moxibustion at Geshu (BL 17), once a day. The consecution treatment of two weeks constituted one session, and totally 4 sessions were given. The total syndrome score, hemorheology index (including low and high shear viscosity of blood, plasma viscosity, hematocrit and erythrocyte aggregation index) and arterial inner dimension of lower extremity (including popliteal artery, posterior tibial artery and dorsalis pedis artery) were compared before and after treatment.</p><p><b>RESULTS</b>Compared with those before treatment, the total syndrome score, hemorheology index and arterial inner dimension of lower extremity were significantly improved after treatment in the two groups (all<0.05). The total syndrome score, hemorheology index in the observation group were superior to those in the control group (all<0.05), but the improvement of arterial inner dimension of lower extremity was not significantly different between the two groups (>0.05). After treatment, the total effective rate was 91.4% (32/35) in the observation group, which was significantly superior to 85.7% (30/35) in the control group (<0.05).</p><p><b>CONCLUSION</b>Moxibustion at Geshu (BL 17) is superior to oral administration of cilostazol for DLAO at early stage, which could effectively improve the clinical symptoms, blood flow and blood vessel and increase the blood flow of lower limb.</p>

Clinical Application of Attic Obliteration in Open-Cavity Tympanoplasty / 听力学及言语疾病杂志

Objective To evaluate the effect of attic obliteration in canal wall down tympanoplasty.Methods A clinical study was performed on 100 ears with chronic otitis media that underwent open-cavity operation and attic obliteration with bone pate in Department of Otology and Skull Base Surgery of Eye and ENT Hospital form January 2010 to January 2015.A pre-and post-operative pure tone air conduction (AC) and bone conduction (BC2) audiogram were obtained 6 months after the surgery.Results There were 1 case with retraction pocket formation and 5 cases with cavity infection in the postoperative follow-up of 1 year to 5 years.The mean preoperative AC threshold of 43.2±2.3 dB HL was lowered to 29.8±1.7 dB HL postoperatively (P＜0.01).The mean preand post-operative air-bone gap was reduced with 10.6±0.5 dB (P＜0.01).Conclusion The attic obliteration with bone pate in open-cavity tympanoplasty prevents the recurrence of cholesteatoma and improves the hearing on condition that total elimination of the lesions.

Comparison of Transjugular Intrahepatic Portosystemic Shunt with Covered Stent and Balloon-Occluded Retrograde Transvenous Obliteration in Managing Isolated Gastric Varices

OBJECTIVE: Although a transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed to manage isolated gastric varices, balloon-occluded retrograde transvenous obliteration (BRTO) has also been used. We compare the long-term outcomes from these procedures based on our institutional experience. MATERIALS AND METHODS: We conducted a retrospective review of patients with isolated gastric varices who underwent either TIPS with a covered stent or BRTO between January 2000 and July 2013. We identified 52 consecutive patients, 27 who had received TIPS with a covered stent and 25 who had received BRTO. We compared procedural complications, re-bleeding rates, and clinical outcomes between the two groups. RESULTS: There were no significant differences in procedural complications between patients who underwent TIPS (7%) and those who underwent BRTO (12%) (p = 0.57). There were also no statistically significant differences in re-bleeding rates from gastric varices between the two groups (TIPS, 7% [2/27]; BRTO, 8% [2/25]; p = 0.94) or in developing new ascites following either procedure (TIPS, 4%; BRTO, 4%; p = 0.96); significantly more patients who underwent TIPS developed hepatic encephalopathy (22%) than did those who underwent BRTO (0%, p = 0.01). There was no statistically significant difference in mean survival between the two groups (TIPS, 30 months; BRTO, 24 months; p = 0.16); median survival for the patients who received TIPS was 16.6 months, and for those who underwent BRTO, it was 26.6 months. CONCLUSION: BRTO is an effective method of treating isolated gastric varices with similar outcomes and complication rates to those of TIPS with a covered stent but with a lower rate of hepatic encephalopathy.

Importancia del método clínico en el diagnóstico de la fístula carótido-cavernosa / Importance of the clinical method in the diagnosis of the carotid-cavernous fistula

Se describe el caso clínico de un paciente de 49 años de edad, que a causa de una crisis hipertensiva presentó una proptosis con enrojecimiento en el ojo derecho, por lo cual recibió diferentes diagnósticos y tratamientos. Debido a que el paciente no mejoraba y aparecían otras manifestaciones clínicas, fue remitido a las consultas de Glaucoma y Neuroftalmología del Centro Oftalmológico de Santiago de Cuba, donde se le realizaron estudios que condujeron al diagnóstico definitivo de fístula arteriovenosa cavernosa carotídea en el lado derecho, indirecta y de bajo flujo. Se indicó compresión manual externa de la carótida, con lo cual se logró la obliteración de la fístula y la mejoría del afectado

The case report of a 49 years patient that presented a proptosis with right eye reddening due to a hipertensive crisis is described, reason why he received different diagnosis and treatments. As the patient didn't improve and other clinical features appeared, he was referred to the Glaucoma and Neurophthalmology Service of the Ophthalmologic Center in Santiago de Cuba, where some studies were carried out which lead to the definitive diagnosis of indirect and of low flow carotid cavernous arteriovenous fistula in the right side. External manual compression of the carotid was indicated and the obliteration of the fistula and improvement of the affected patient was achieved

Mastoid Obliteration with Autologous Bone in Mastoidectomy Canal Wall Down Surgery: a Literature Overview

Introduction The objectives of mastoidectomy in cholesteatoma are a disease-free and dry ear, the prevention of recurrent disease, and the maintenance of hearing or the possibility to reconstruct an affected hearing mechanism. Canal wall down mastoidectomy has been traditionally used to achieve those goals with greater or lesser degrees of success. However, canal wall down is an aggressive approach, as it involves creating an open cavity and changing the anatomy and physiology of themiddle ear andmastoid. A canal wall up technique eliminates the need to destroy the middle ear and mastoid, but is associated with a higher rate of residual cholesteatoma. The obliteration technics arise as an effort to avoid the disadvantages of both techniques. Objectives Evaluate the effectiveness of the mastoid obliteration with autologous bone in mastoidectomy surgery with canal wall down for chronic otitis, with or without cholesteatoma. Data Synthesis We analyzed nine studies of case series comprehending similar surgery techniques on 1017 total cases of operated ears in both adults and children, with at least 12 months follow-up. Conclusion Mastoid Obliteration with autologous bone has been utilized for many years to present date, and it seems to be safe, low-cost, with low recurrence rates - similar to traditional canal wall down procedures and with greater water resistance and quality of life improvements.

Modified Right Ventricular Obliteration Technique for Fontan Candidates with Non-functional Right Ventricle / 日本心臓血管外科学会雑誌

<b>Introduction</b> : Right atrial (RA) and right ventricular (RV) dilatation that are associated with severe tricuspid regurgitation, and severe high RV pressure that is associated with pulmonary atresia and intact ventricular septum cause left ventricular (LV) dysfunction and hypoplastic lung. We have applied a modified RV obliteration technique that excludes non-functional enlarged RV for these diseases. <b>Objectives</b> : To evaluate the efficacy of our procedure. <b>Methods and Results</b> : Five patients (six operations) underwent the procedure without complications. Cardiothoracic ratio significantly decreased from 71±10% to 61±5% (<i>p</i>=0.017), and fractional shortening ended to increase from 27±17% to 37±5% (<i>p</i>=0.071). All of them achieved Fontan completion finally. One patient who underwent this procedure as a neonate experienced RV re-dilation 19 months later. He additionally received the same procedure in a Fontan operation, and then RV reduced again and good LV function was maintained. <b>Conclusion</b> : The application of modified RV obliteration technique is effective for Fontan candidates with nonfunctional RV.

Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

OBJECTIVE: To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices. MATERIALS AND METHODS: Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy. RESULTS: Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality. CONCLUSION: BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

Balloon Occlusion Retrograde Transvenous Obliteration of Gastric Varices in Two Non-Cirrhotic Patients with Portal Vein Thrombosis

This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.