title: [Digestive hemorrhage caused by duodenal varices].
abstract: Duodenal varices are uncommon and are frequently diagnosed late. However, they are a potential cause of massive bleeding, with tendency to relapse. We would like to offer as an example a case diagnosed by means of an endoscopy. A patient without oesophageal varices and with obstruction of the splenic-portal axis and venous calcifications is reported. A diminution in the volume of the duodenal varices with inspiratory movements may help in the differential diagnosis during endoscopy. We emphasize the need of avoiding incorrect maneuvers during endoscopy and the value of ultrasonography and CAT scan to confirm the diagnosis. Sclerotherapy appears to be the best therapeutic approach. Percutaneous embolization and surgery are therapeutic alternatives if sclerosis is not effective. However, in some cases with self-limited bleeding and a low tendency to relapse, as with the patient described herein, a conservative attitude should be selected.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Virgen Macarena, Sevilla.
authors.forename: M
authors.initials: M
authors.lastname: Jiménez Saenz
authors.forename: H
authors.initials: H
authors.lastname: Pallarés Manrique
authors.forename: R
authors.initials: R
authors.lastname: Romero Castro
authors.forename: A
authors.initials: A
authors.lastname: Piñar Moreno
authors.forename: M
authors.initials: M
authors.lastname: Gómez Parra
authors.forename: J M
authors.initials: JM
authors.lastname: Herrerías Gutiérrez
mesh_terms: D000368:Aged; D004378:Duodenal Diseases / Q000209:etiology*; D004386:Duodenum / Q000098:blood supply*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D014648:Varicose Veins / Q000150:complications*
vernacular_title: Hemorragia digestiva por varices duodenales.