Duodenal Varices Causing Massive Upper Gastrointestinal Hemorrhage.
- Author:
Jin Kyung KANG
;
In Suh PARK
;
Jae Bock CHUNG
;
Si Young SONG
;
Kun Hoon SONG
;
Yong Chan LEE
;
Jin Heon LEE
- Publication Type:Case Report
- Keywords:
Duodenal varices;
Upper gastrointestinal hemorrhage
- MeSH:
Decompression;
Duodenum;
Esophageal and Gastric Varices;
Esophagus;
Gastrointestinal Hemorrhage*;
Hemorrhage;
Humans;
Hypertension, Portal;
Liver Cirrhosis;
Mucous Membrane;
Sclerotherapy;
Ulcer;
Varicose Veins*
- From:Korean Journal of Gastrointestinal Endoscopy
1996;16(3):493-503
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The bleeding duodenal varices are a rare complication in patients with portal hypertension, but present a difficult diagnostic problem. If there is no bleeding esophageal, gastric fundal varices or ulcer in a patient with upper gastrointestinal bleeding and portal hypertension, the possibility of bleeding duodenal varices should be kept in mind. Thorough endoscopic examination of the entire duodenal mucosa is essential to document bleeding from duodenal varices. As an initial treatment, endoscopic sclerotherapy has had limited success in controlling active duodenal variceal bleeding. However, rebleeding rate is high, surgical treatment including shunt operation may be required for permanent control of bleeding and portal decompression. We report three cases of duodenal varices causing massive hemorrhage. All the patients had portal hypertension caused by liver cirrhosis of various etiologies and had varices in their esophagus. The second portion of the duodenum was the site of duodenal varices in all cases. The management was tailored to the condition of each patient, but only one patient among three survived.
