A rare case of duodenal variceal bleeding due to extrahepatic portal vein obstruction successfully treated with endoscopic injection sclerotherapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-04-04

AUTHORS

Ashu Hori, Yusuke Watanabe, Kazuya Takahashi, Takahumi Tonouchi, Naruhiro Kimura, Toru Setsu, Satoshi Ikarashi, Hiroteru Kamimura, Junji Yokoyama, Shuji Terai

ABSTRACT

Primary extra-hepatic portal vein obstruction (EHPVO) is a disease that develops ectopic varices due to portal hypertension and obstruction of the portal vein. Since bleeding from ectopic varices is life-threatening, the management of ectopic varices is important for patients with primary EHPVO. Here, we report a case of duodenal variceal bleeding in a patient with primary EHPVO. A 39-year-old man was diagnosed with F2-shaped duodenal varices (DV) due to primary EHPVO and was first treated with endoscopic variceal ligation for temporary hemostasis. We then performed angiography to understand the detailed hemodynamics and subsequently conducted endoscopic injection sclerotherapy (EIS) with a sclerosing agent containing N-butyl-2-cyanoacrylate for further hemostasis. After the treatment, dynamic computed tomography and endoscopic ultrasound revealed that the blood flow to the causative DV disappeared, although the DV itself remained. The patient was discharged without any re-bleeding or adverse events. Since treatment for DV due to primary EHPVO differs depending on hemodynamics (hepatofugal or hepatopetal blood flow), evaluating detailed hemodynamics for optimal treatment selection is crucial. Although EIS for this patient was not a radical treatment, it was effective in managing acute bleeding from the DV. This case will serve as a reference for successful treatment in future cases. More... »

PAGES

1-6

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12328-022-01627-3

DOI

http://dx.doi.org/10.1007/s12328-022-01627-3

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https://app.dimensions.ai/details/publication/pub.1146861895

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35378714


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