Transabdominal color Doppler ultrasonography for the diagnosis of small intestinal and vesical varices in a patient successfully treated with percutaneous transhepatic obliteration.

A 52-year-old asymptomatic female was admitted to our hospital in January 2008 with enlarged esophageal varices due to alcoholic liver cirrhosis. Color Doppler ultrasonographic examination showed images of vessels on the small intestinal wall around the umbilical area and the anterior wall of the bladder. Images of the vessels were obtained for the small intestinal wall and the anterior wall of the bladder with computed tomography. Percutaneous transhepatic portography was performed, and hepatofugal blood flow was observed in the inferior epigastric vein connected to the superior mesenteric vein and the contrast medium passed into the small intestinal varices and the vesical varices, which drained into the right ovarian vein. Percutaneous transhepatic obliteration was then successfully performed via the afferent veins of the small intestinal varices and vesical varices. One week after the treatment, color Doppler ultrasonography showed a remarkable decrease in blood flow in the varices.