The type, incidence, and severity of complications of balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices should be precisely estimated. Complications were evaluated in 38 patients who had fundic gastric varices and 43 B-RTO procedures during injection of ethanolamine oleate (phase 1), within 4 h after injection (phase 2), 24 h after injection (phase 3), and from 24 h to 10 days after injection (phase 4). Endoscopic evaluation at 8 weeks showed resolution of gastric varices in 35 of 38 patients (92%) and smaller varices in the remaining three (8%). B-RTO caused transient hypertension in 35% of patients, hemoglobinuria in 49%, and fever in 33% during phases 1, 2, and 3, respectively. Pleural effusion, pulmonary infarction, ascites, gastric ulcers with unique appearance, localized mosaic-like change of gastric mucosa, and hemorrhagic portal hypertensive gastropathy were noted in phase 4. There were no fatalities. Lactate dehydrogenase, aspartate aminotransferase, and bilirubin increased on day 1. Each datum was retrieved within 7 days. The severity of lactate dehydrogenase elevation correlated significantly with the volume of infused ethanolamine oleate. Thus, B-RTO is a safe and effective management of fundic varices. However, short-term hemodynamic change after B-RTO may cause gastric mucosal damage. Pulmonary infarction and pleural effusion are potential complications.

Background: Several cases of horseshoe kidney with anomalous inferior vena cava (IVC) have been described, but there have been no reports of the incidence and variation of anomalous IVC in patients with horseshoe kidneys detected using multidetector row computed tomography (MDCT). Methods and Results:105 patients with horseshoe kidneys were evaluated with MDCT and a variety of venous anomalies were identified in 30 patients (28.6%). Anatomical variations of the renal vein were identified in 24 patients (22.9%), which was no higher than the reported incidence in the general population. However, variations of the IVC were identified in 6 patients (5.7%), which was a higher incidence than expected to be found in the general population: 1 pre-isthmic IVC with retrocaval ureter, 2 double IVCs posterior to the horseshoe kidney, 2 left IVCs posterior to the horseshoe kidney, and 1 azygos continuation of the IVC. Conclusions:Horseshoe kidneys are frequently found in patients with other venous, and particularly IVC, anomalies, which should be evaluated using MDCT as part of treatment planning. (Circ J 2011; 75: 2872 - 2877

DCCTE showed the entire colon without blind spots in nearly all patients in the PEG-C preparation group because the areas under residual fluid were reconstructed as contrast medium images. DCCTE and conventional colonoscopy after PEG-C preparation are feasible and safe procedures that can be used for preoperative evaluation in patients with colorectal cancer.

Objective: Persistent left superior vena cava without bringing vein (PLSVC w/o BV) is a common thoracic venous anomaly, while aberrant left brachiocephalic vein (ALBCV) is an uncommon condition. We compared the incidences of the two venous anomalies and assessed congenital cardiovascular diseases (CCDs) in adults using computed tomography (CT).Materials and Methods: We reviewed the recorded reports or CT images of 49,494 adults for PLSVC w/o BV and ALBCV in two hospitals. We determined incidences of two venous anomalies and the rate of associated CCDs.Results: 76 PLSVCs w/o BV and 27 ALBCVs were found. The incidence of PLSVC w/o BV was 0.15% and the incidence of ALBCV was 0.055%. PLSVC w/o BV had higher incidence than ALBCV (p<0.001). Four PLSVCs w/o BV and one ALBCV were associated with congenital heart diseases. Two PLSVCs w/o BV and four ALBCVs were associated with congenital aortic arch anomaly (CAAA). ALBCV had higher incidence of associated CAAA than PLSVC w/o BV (P=0.02).Conclusion: The incidence of ALBCV was <50% that of PLSVC w/o BV. The two venous anomalies found on CT during adulthood were rarely associated with CCDs.

Aberrant left BCV on CT examination in adults was extremely rare. Some cases were associated with aortic arch anomalies.