Ruptured duodenal varices arising from the main portal vein successfully treated with endoscopic injection sclerotherapy: a case report.
10.3350/kjhep.2011.17.2.152
- Author:
Ha Yan KANG
1
;
Won Kyung LEE
;
Yong Hyun KIM
;
Byung Woon KWON
;
Myung Soo KANG
;
Suk Bae KIM
;
Il Han SONG
Author Information
1. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea. ihsong21@dankook.ac.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't
- Keywords:
Duodenal varices;
Endoscopic injection sclerotherapy;
Portal hypertension;
Cirrhosis
- MeSH:
Cyanoacrylates/therapeutic use;
Duodenal Diseases/diagnosis/etiology/*therapy;
Duodenum/*blood supply;
Endoscopy, Gastrointestinal;
Gastrointestinal Hemorrhage/etiology/*therapy;
Humans;
Male;
Middle Aged;
Portal Vein;
Rupture;
Sclerosing Solutions/therapeutic use;
*Sclerotherapy;
Tomography, X-Ray Computed;
Varicose Veins/complications/*therapy
- From:The Korean Journal of Hepatology
2011;17(2):152-156
- CountryRepublic of Korea
- Language:English
-
Abstract:
Duodenal varices result from retroperitoneal portosystemic shunts that usually come from the pancreaticoduodenal vein and drain into the inferior vena cava. Because they are a rare but fatal cause of gastrointestinal bleeding, a prompt hemostatic intervention is mandatory. A 62-year-old man who had a history of excessive alcohol consumption presented with massive hematemesis and melena. Emergent endoscopy revealed ruptured varices with an adhering whitish fibrin clot on the postbulbar portion of the duodenum. Abdominal computed tomography demonstrated a cirrhotic liver with venous collaterals around the duodenum and extravasated contrast in the second and third portions. The collaterals originated from the main portal vein and drained via the right renal vein into the inferior vena cava. Endoscopic injection sclerotherapy with cyanoacrylate was successful in achieving hemostasis, and resulted in the near eradication of duodenal varices at a 6-month follow-up.
