Introduction: We present a case of upper gastrointestinal bleeding in a woman aged 56 years with liver cirrhosis who was diagnosed with isolated duodenal variceal bleeding, which was successfully treated with histoacr...Introduction: We present a case of upper gastrointestinal bleeding in a woman aged 56 years with liver cirrhosis who was diagnosed with isolated duodenal variceal bleeding, which was successfully treated with histoacryl injection. Case Presentation: A 57-year female cirrhotic patient presented with melena. She had been diagnosed with duodenal variceal bleeding and treated successfully with 2.4 ml histoacryl using a normal gastroscope. The patient subsequently remained stable and free of any further GI bleeding. She was discharged 48 hours later. Her hemoglobin remained stable at 9 g/L. Conclusion: The histoacryl glue injection provides an effective treatment. Hence, this should ideally be performed by an experienced endoscopist who is aware of and vigilant for the serious complications of this treatment option.展开更多
BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duode...BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension(IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt(TIPS) plus embolization. CASE SUMMARY A 46-year-old woman with anemia for two years was frequently admitted to the local hospital. Upon examination, anemia was attributed to gastrointestinal tract bleeding, which resulted from duodenal variceal bleeding detected by repeated esophagogastroduodenoscopy. At the end of a complete workup, IPH leadingto duodenal varices was diagnosed. Portal venography revealed that the remarked duodenal varices originated from the proximal superior mesenteric vein. TIPS plus embolization with coils and Histoacryl was performed to obliterate the rupture of duodenal varices. The anemia resolved, and the duodenal varices completely vanished by 2 mo after the initial operation. CONCLUSION TIPS plus embolization may be more appropriate to treat the bleeding of large duodenal varices.展开更多
文摘Introduction: We present a case of upper gastrointestinal bleeding in a woman aged 56 years with liver cirrhosis who was diagnosed with isolated duodenal variceal bleeding, which was successfully treated with histoacryl injection. Case Presentation: A 57-year female cirrhotic patient presented with melena. She had been diagnosed with duodenal variceal bleeding and treated successfully with 2.4 ml histoacryl using a normal gastroscope. The patient subsequently remained stable and free of any further GI bleeding. She was discharged 48 hours later. Her hemoglobin remained stable at 9 g/L. Conclusion: The histoacryl glue injection provides an effective treatment. Hence, this should ideally be performed by an experienced endoscopist who is aware of and vigilant for the serious complications of this treatment option.
基金Supported by National Natural Science Foundation of China under Grant No.81503437
文摘BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension(IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt(TIPS) plus embolization. CASE SUMMARY A 46-year-old woman with anemia for two years was frequently admitted to the local hospital. Upon examination, anemia was attributed to gastrointestinal tract bleeding, which resulted from duodenal variceal bleeding detected by repeated esophagogastroduodenoscopy. At the end of a complete workup, IPH leadingto duodenal varices was diagnosed. Portal venography revealed that the remarked duodenal varices originated from the proximal superior mesenteric vein. TIPS plus embolization with coils and Histoacryl was performed to obliterate the rupture of duodenal varices. The anemia resolved, and the duodenal varices completely vanished by 2 mo after the initial operation. CONCLUSION TIPS plus embolization may be more appropriate to treat the bleeding of large duodenal varices.
