Treatment of colonic varices and gastrointestinal bleeding by recanalization and stenting of splenic-vein-thrombosis: A case report and literature review

Figure 1 Dilated and tortuous colonic varices on endoscopy without active bleeding. A: Right transverse colon; B: Right colonic flexure.

Figure 2 Angiography images and computed tomography images. A: Angiography of splenic artery; B: Angiography of the mesenterial vein draining the spleen; C: Computed tomography (CT)-angiography showing colonic varices; D-G: 3D-Reconstruction of CT imaging. 3D-Reconstruction with the thrombosis of the splenic vein (arrowhead) and collateral vessels to the colon indicated by arrows.

Figure 3 Angiography images. A: Right portal vein access; B: Simultaneously performed direct portography and indirect mesentericography via the splenic artery showing complete obstruction of the splenic vein; C: Successful cannulation of the obstructed splenic vein (SV); D: Phlebography of the colonic varices (CV) arising from the splenic hilum; E: Recanalization of the SV using balloon and stentgrafts; F: Successful recanalization of the SV; G: Coiling of the aberrant vein feeding the CV; H: Patent stentgraft with drainage of the spleen through the splenic vein.

Figure 4 Follow-up colonoscopy. A: Right colonic flexure 2 mo after intervention; B: Transverse colon 1 year after intervention.