• 1.

    Song L et al., 2016. Assessment of the effect of treatment and assistance program on advanced patients with schistosomiasis japonica in China from 2009 to 2014. Parasitol Res 115: 42674273.

    • Search Google Scholar
    • Export Citation
  • 2.

    Toews I, George AT, Peter JV, Kirubakaran R, Fontes LES, Ezekiel JPB, Meerpohl JJ, 2018. Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units. Cochrane Database Syst Rev 6: CD8687.

    • Search Google Scholar
    • Export Citation
  • 3.

    Cho SH, Lee YS, Kim YJ, Sohn CH, Ahn S, Seo DW, Kim WY, Lee JH, Lim KS, 2018. Outcomes and role of urgent endoscopy in high-risk patients with acute nonvariceal gastrointestinal bleeding. Clin Gastroenterol Hepatol 16: 370377.

    • Search Google Scholar
    • Export Citation
  • 4.

    Gioia S, Merli M, Nardelli S, Lattanzi B, Pitocchi F, Ridola L, Riggio O, 2019. The modification of quantity and quality of muscle mass improves the cognitive impairment after TIPS. Liver Int 39: 871877.

    • Search Google Scholar
    • Export Citation
  • 5.

    Zhang K, Sun X, Wang G, Zhang M, Wu Z, Tian X, Zhang C, 2019. Treatment outcomes of percutaneous transhepatic variceal embolization versus transjugular intrahepatic portosystemic shunt for gastric variceal bleeding. Medicine (Baltimore) 98: e15464.

    • Search Google Scholar
    • Export Citation
  • 6.

    Monzawa S, Uchiyama G, Ohtomo K, Araki T, 1993. Schistosomiasis japonica of the liver: contrast-enhanced CT findings in 113 patients. AJR Am J Roentgenol 161: 323327.

    • Search Google Scholar
    • Export Citation
  • 7.

    Wu S et al., 2018. Evaluation of transient elastography in assessing liver fibrosis in patients with advanced schistosomiasis japonica. Parasitol Int 67: 302308.

    • Search Google Scholar
    • Export Citation
  • 8.

    Li Y, Yang G, Qiang J, Cai S, Zhou H, 2016. Incidence of insulin resistance and diabetes in patients with portosystemic shunts without liver dysfunction. J Int Med Res 44: 10401048.

    • Search Google Scholar
    • Export Citation
  • 9.

    Zhu K, Meng X, Zhou B, Qian J, Huang W, Deng M, Shan H, 2013. Percutaneous transsplenic portal vein catheterization: technical procedures, safety, and clinical applications. J Vasc Interv Radiol 24: 518527.

    • Search Google Scholar
    • Export Citation
  • 10.

    Gong GQ, Wang XL, Wang JH, Yan ZP, Cheng JM, Qian S, Chen Y, 2001. Percutaneous transsplenic embolization of esophageal and gastrio-fundal varices in 18 patients. World J Gastroenterol 7: 880883.

    • Search Google Scholar
    • Export Citation
  • 11.

    Qian C, Zhang Y, Zhang X, Yuan C, Gao Z, Yuan H, Zhong J, 2018. Effectiveness of the new integrated strategy to control the transmission of Schistosoma japonicum in China: a systematic review and meta-analysis. Parasite 25: 54.

    • Search Google Scholar
    • Export Citation
  • 12.

    Wang LD et al., 2009. A strategy to control transmission of Schistosoma japonicum in China. N Engl J Med 360: 121128.

  • 13.

    Chofle AA et al., 2014. Oesophageal varices, schistosomiasis, and mortality among patients admitted with haematemesis in Mwanza, Tanzania: a prospective cohort study. BMC Infect Dis 14: 303.

    • Search Google Scholar
    • Export Citation
  • 14.

    Masi B, Perles-Barbacaru TA, Bernard M, Viola A, 2020. Clinical and preclinical imaging of hepatosplenic schistosomiasis. Trends Parasitol 36: 206226.

    • Search Google Scholar
    • Export Citation
  • 15.

    Chu HH, Kim HC, Jae HJ, Yi NJ, Lee KW, Suh KS, Chung JW, Park JH, 2012. Percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver disease. Cardiovasc Intervent Radiol 35: 13881395.

    • Search Google Scholar
    • Export Citation
  • 16.

    Ohta M, Hashizume M, Kawanaka H, Akazawa K, Ueno K, Tomikawa M, Kishihara F, Tanoue K, Sugimachi K, 1996. Complications of percutaneous transhepatic catheterization of the portal venous system in patients with portal hypertension. J Gastroenterol Hepatol 11: 630634.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

Treatment of Upper Gastrointestinal Bleeding by Percutaneous Transsplenic Varices Embolization in Chronic Hepatic Schistosomiasis Japonicum Patients

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  • 1 Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China;
  • | 2 Department of Intervention Radiology, Jinshan Hospital, Fudan University, Shanghai, China

ABSTRACT.

To evaluate percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal bleeding (UGIB) in patients with chronic hepatic schistosomiasis japonicum (CHS), 29 CHS patients (20 males and 9 females) complicated with UGIB were selected as the investigation subjects. The patients were treated by PTSVE under the guidance of X-ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition, the degrees of varices before and after PTSVE were evaluated by abdominal computed tomography (CT). Results showed that 26 CHS patients (89.6%) were successfully treated with PTSVE. Three cases (10.3%) failed, and two experienced intraperitoneal bleeding within 1 week after PTSVE. The abdominal CT showed a significant decrease of the varices stage in coronary (P < 0.001), esophageal (P = 0.006), and paraesophageal (P = 0.013) varices, but slightly increased perisplenic varices within 1 month of the intervention (P = 0.014). PTSVE may be a safe and effective procedure for the treatment of UGIB in CHS patients, particularly suitable for those with a widened hepatic fissure and exposed hepatic portal vein trunk and an enlarged spleen.

Author Notes

Address correspondence to Jin Wei Qiang, Department of Radiology, Jinshan Hospital, Fudan University, Longhang Road 1508#, Shanghai, China. E-mail: dr.jinweiqiang@163.com

These authors contributed equally to this study

Financial support: This study was supported by National Natural Science Foundation of China (81971579) and also by Shanghai Municipal Commission of Health (No. ZK2019B01).

Authors’ addresses: Ying Li, Ban Sheng Cai, Xin Li, Xiu Ying Yang, and Jin Wei Qiang, Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China, E-mails: dr.yingli@foxmail.com, 987795174@qq.com, 362990170@qq.com, dryangyingzi@foxmail.com, and dr.jinweiqiang@163.com. Shuai Ju, Department of Intervention Radiology, Jinshan Hospital, Fudan University, Shanghai, China, E-mail: 877210952@qq.com.

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