PMC3542309_01
50-year-old male presented to ED with recurrent episodes of gross hematuria.. A. Cystoscopy shows vesical varices (arrow). B, C. CT images show dilated blood vessels (arrow) along right side of bladder wall with drainage into superior mesenteric vein. D. Arterial portography via superior mesenteric artery shows dilated veins drainaged (drained) into superior mesenteric vein (SMV) in right pelvic area. E. Percutaneous transhepatic portography shows vesical varices with drainage into SMV. F. Balloon-occluded venogram shows vesical varices. G. Figure shows opacification of vesical varices with 5% ethanolamine oleate-lipiodol mixture (arrow).. H, I. CT images shows opacification of vesical varices (arrow) with 5% ethanolamine oleate-lipiodol mixture after 6 weeks. J. F/U Cystoscopy shows disappearance of vesical varices after 6 weeks.
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F1
October 2009 with gross hematuria and underwent transurethral cystoscopic coagulation of varices in the urinary bladder (Fig. 1A). On arrival to our ED, he was initially treated with saline bladder irrigation and blood transfusion. Additional varix was not presented in the CT images (Fig. 1B, C). Arterial portographies via the superior mesenteric artery showed dilated veins draining into the SMV in the right pelvic area (Fig. 1D). A retrograde venogram was obtained while the outflow tract was occluded with the balloon (Fig. 1E, F). After approximately 15 minutes, complete occlusion of the varices was observed during deflation of the balloon catheter (Fig. 1G). After 6 weeks, CECT showed well obliterated vesical varices and the patient did not complain of gross hematuria (Fig. 1H, J). Follow-up cystoscopy showed the disappearance of vesical varices (Fig. 1J).