Abstract
Treatment of abdominal lymphoma can be associated with bowel stricture or perforation. Rarely, the common bile duct or portal vein can be involved. This is the first case of stricture formation of both the portal vein and common bile duct in a patient following successful treatment of lymphoma. The development of extensive hilar varices rendered surgical management high risk. A staged approach to treatment was used. First, a percutaneous portal vein stent was placed, resulting in resolution of the hilar varices. This was followed by a surgical hepaticojejunostomy, performed without complication. Gastrointestinal complications are rare following treatment of lymphoma but may affect a variety of sites. The safe and effective treatment of this case highlights the benefit of a multidisciplinary approach to complex medical and surgical problems.
Highlights
Treatment of abdominal lymphoma can be associated with bowel stricture or perforation
Gastrointestinal complications can follow treatment of abdominal lymphoma due to tumour necrosis and include bowel perforation or stricture formation. This is the first report of combined common bile duct (CBD) and portal vein (PV) stricture following treatment of abdominal lymphoma
The biliary stent was removed with cholangiography demonstrating no CBD stricture
Summary
Keith Roberts, c/o Mr Toogood, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK. Gastrointestinal complications can follow treatment of abdominal lymphoma due to tumour necrosis and include bowel perforation or stricture formation. This is the first report of combined common bile duct (CBD) and portal vein (PV) stricture following treatment of abdominal lymphoma. Computed tomography (CT) demonstrated no evidence of disease recurrence but highlighted stenosis of the main PV with cavernous reformation and the presence of large varices (Fig 2). She was referred for bile duct reconstruction but at a multidisciplinary forum it was agreed that this would be difficult due to the extensive hilar varices
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