Clin Endosc.  2013 Jul;46(4):403-406.

Successful Treatment of Duodenal Variceal Bleeding by Endoscopic Clipping

• Park SB
• Lee SH
• Kim JH
• Lee HJ
• Jang SP
• Lee JN
• Hwang JH

Abstract

Duodenal varix bleeding is an uncommon cause of gastrointestinal bleeding in patients with portal hypertension but can cause severe and potentially fatal bleeding. However, the incidence is low and a good treatment method has not been well established yet. Duodenal variceal bleeding can be treated surgically or nonsurgically. We have successfully treated a patient with duodenal variceal bleeding secondary to liver cirrhosis using hemoclips to control the bleeding.

Keyword

Gastrointestinal bleeding; Duodenal varix; Endoscopic clipping

MeSH Terms

Hemorrhage
Humans
Hypertension, Portal
Incidence
Liver Cirrhosis
Varicose Veins

Figure

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  Fig. 1 Pulsating varix with hemorrhagic stigmata in the bulb of duodenum, an ulceration with exposed vessel on the varix.

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  Fig. 2 Efferent vein and afferent vein were ligated using hemoclips to achieve hemostasis.

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  Fig. 3 Three dimensional computed tomographic angiography after treatment. Extensive collateral varix around the duodenum due to thrombosis in the main portal vein and splenic vein (arrow).

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  Fig. 4 Follow-up endoscopy 3 days after hemoclipping of the duodenal varix revealing a small ulcer.

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  Fig. 5 Follow-up endoscopy 3 months after duodenal varix bleeding.

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