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Erschienen in:
11.06.2021 | Letter to the Editor
Percutaneous Mesocaval Shunt Creation Using Radiofrequency Wire
Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 10/2021
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We present a 64-year-old male with a history of pancreatic adenocarcinoma, status post-pancreaticoduodenectomy and neoadjuvant chemotherapy, who underwent a surveillance PET/CT scan which demonstrated local recurrence involving the proximal SMV, requiring a redo pancreaticojejunostomy, portal vein/SMV confluence resection, and intraoperative radiation therapy. Three months later, the patient developed melenic stools and symptomatic anemia requiring admission. A contrast-enhanced CT demonstrated multiple small bowel varices and venous collaterals (Fig. 1). An endoscopy confirmed the presence of small bowel varices with signs of recent bleeding. Multi-disciplinary discussions deemed the patient a poor surgical candidate and therefore a percutaneous mesocaval shunt was attempted.
Fig. 1
Sagittal contrast-enhanced CT image demonstrating dense fibrous tissue (white arrow) between the superior mesenteric vein (black arrow) and the inferior vena cava (asterix)
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