Int J Gastrointest Interv.  2019 Oct;8(4):174-177. 10.18528/ijgii190002.

A case report of bleeding from duodenal varices treated with percutaneous transhepatic obliteration

Affiliations
  • 1Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea. nicewon@hanmail.net
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Vascular and Interventional Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Abstract

Duodenal varices are ectopic in nature and account for 40% of all ectopic bleeding cases. Ectopic variceal bleeding is rare (1%-5% of all variceal bleeding cases). The three principle approaches used to treat duodenal varices are endoscopic procedures, interventional radiological methods, and surgical interventions. A 59-year-old male with alcoholic liver cirrhosis and chronic hepatitis B infection visited our gastroenterology department with melena. Gastroduodenoscopy and computed tomography identified varices in the second part of the duodenum. We performed percutaneous transhepatic obliteration using glue and coil embolization, which obliterated the varices and resulted in immediate hemostasis. However, 3 months later, he re-visited presenting with newly developed duodenal varices and underwent endoscopic injection sclerotherapy.

Keyword

Duodenal varices; Ectopic varices; Endoscopic injection sclerotherapy; Percutaneous transhepatic obliteration

MeSH Terms

Adhesives
Duodenum
Embolization, Therapeutic
Esophageal and Gastric Varices
Gastroenterology
Hemorrhage*
Hemostasis
Hepatitis B, Chronic
Humans
Liver Cirrhosis, Alcoholic
Male
Melena
Middle Aged
Sclerotherapy
Varicose Veins*
Adhesives
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