Open AccessMassive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review
Author(s) -
Christopher Steevens,
Maisa Abdalla,
Truptesh Kothari,
Vivek Kaul,
Shivangi Kothari
Publication year - 2015
Publication title -
world journal of gastrointestinal pharmacology and therapeutics
Language(s) - English
Resource type - Journals
ISSN - 2150-5349
DOI - 10.4292/wjgpt.v6.i4.248
Subject(s) - medicine , portal hypertension , sclerotherapy , varices , bleed , cirrhosis , complication , gastrointestinal bleeding , gastroenterology , population , surgery , radiology , environmental health
Bleeding from duodenal varices is reported to be a catastrophic and often fatal event. Most of the cases in the literature involve patients with underlying cirrhosis. However, approximately one quarter of duodenal variceal bleeds is caused by extrahepatic portal hypertension and they represent a unique population given their lack of liver dysfunction. The authors present a case where a 61-year-old male with history of remote crush injury presented with bright red blood per rectum and was found to have bleeding from massive duodenal varices. Injection sclerotherapy with ethanolamine was performed and the patient experienced a favorable outcome with near resolution of his varices on endoscopic follow-up. The authors conclude that sclerotherapy is a reasonable first line therapy and review the literature surrounding the treatment of duodenal varices secondary to extrahepatic portal hypertension.