Emergency transumbilical embolization of bleeding esophageal varices
J. W. Tauber, R. J. Baker, D. G. Spigos, S. L. Winter, T. J. Layden and L. M. Nyhus
Eight patients had major hemorrhage from esophageal varices; in seven, one
or two embolizations of the coronary and short gastric veins resulted in
cessation of hemorrhage. This procedure can be used in patients with
massive ascites, severe coagulopathy, or profound liver failure, as the
access route through the dilated umbilical vein can be reached via a
supraumbilical incision done with the patient under local anesthesia. All
patients died; two deaths were attributable to complications of the
procedure, the other six to the severity of the cirrhosis. Sclerotherapy
may be combined with coronary vein embolization, but the risk of esophageal
perforation may be greater than with sclerotherapy alone.