Rupture of small intestinal varices diagnosed by CTAP and gastrointestinal bleeding scintigraphy and treated by percutaneous phlebosclerozation angioembolization

A 55-year-old man was admitted to our hospital because of massive gastrointestinal bleeding. He had a history of type B liver cirrhosis, multiple abdominal surgeries, and endoscopic treatment of esophageal varices. Colonoscopy was performed, but the source of bleeding could not be identified. Computed tomography during arterial portography (CTAP) demonstrated small intestinal varices and collateral veins from the superior mesenteric vein to the epigastric vein. We performed phlebosclerozation by directly puncturing the epigastric vein under the skin. Remission of bleeding was then attained. No recurrence of gastrointestinal hemorrhage has occurred after the phlebosclerozation. We believe that CTAP is useful when diagnosing small intestinal varices and that percutaneous phlebosclerozation should be considered as a treatment option for small intestinal varices.