Usefulness of multi-detector row computed tomography for management of duodenal varices by emergency balloon-occluded retrograde transvenous obliteration

Ectopic varices outside the gastroesophageal region are less common in patients with portal hypertension and liver cirrhosis. Among ectopic varices, bleeding from duodenal varices is often massive and fatal. Several reports have recently described various treatment options for duodenal varices including interventional radiology. It is necessary to thoroughly investigate variceal hemodynamics before conducting interventional radiology. We report a case of bleeding duodenal varices treated successfully with balloon-occluded retrograde transvenous obliteration (B-RTO) after investigating the hemodynamics of the duodenal varices with multi-detector row computed tomography (MDCT). MDCT easily identified the duodenal varices together with the afferent and efferent vessels. Our case suggests the usefulness of MDCT before B-RTO for investigating the hemodynamics and vascular anatomy of the duodenal varices and selection of the most appropriate therapy.