Massive and recurrent gastrointestinal hemorrhage due to jejunal varices in an afferent loop--diagnosis and management.
Bleeding from "ectopic" varices outside the gastroesophageal region is an uncommon complication of portal hypertension. Although the high mortality rate of bleeding duodenal varices has been emphasized (1-4), an awareness of the condition and its characteristic presentation may enable diagnostic and therapeutic procedures to be performed rapidly with an increased likelihood of a successful outcome. This report describes a patient with recurrent, frequent and massive hemorrhage from jejunal varices in the afferent loop after a Billroth II resection, chronic pancreatitis and portal hypertension; the diagnosis and management of this unusual case of recurrent gastrointestinal bleeding are discussed.
Department of Surgery, Heinz-Kalk-Krankenhaus, Bad Kissingen, Germany.
K J
KJ
Paquet
A
A
Lazar
J
J
Bickhart
D000328:Adult; D002908:Chronic Disease; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005774:Gastrostomy; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007582:Jejunostomy; D007583:Jejunum / Q000098:blood supply*; D008297:Male; D010195:Pancreatitis / Q000150:complications*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D014648:Varicose Veins / Q000175:diagnosis / Q000209:etiology / Q000601:surgery