title: [Massive hemorrhage from jejunal varices].
abstract: A 21-year-old male presented with melaena and signs of hemorrhagic shock. In the following days several episodes of hematochezia occurred requiring the transfusion of nine units of blood. Findings at gastroscopy were normal, at colonoscopy fresh blood was noted from the ileocecal valve. Angiography performed in a bleeding-free interval showed no abnormalities. At repeat angiography, bleeding (from a left lateral branch of the superior mesenteric artery) was provoked by instillation of plasminogen activator. Subsequently, hemostasis was achieved by superselective embolization using coils. At operation one week later, a polypoid tumor of 1 cm diameter was resected along with a 4 cm segment of adjacent jejunum (40 cm distal to the ligament of Treitz). Histologically, a jejunal varix with superficial ulceration was diagnosed.
authors.affiliation: Medizinische Universitätsklinik, Würzburg.
authors.forename: W
authors.initials: W
authors.lastname: Scheppach
authors.forename: G
authors.initials: G
authors.lastname: Wittenberg
authors.forename: D
authors.initials: D
authors.lastname: Hahn
authors.forename: H
authors.initials: H
authors.lastname: Langenfeld
authors.forename: W
authors.initials: W
authors.lastname: Burghardt
authors.forename: M
authors.initials: M
authors.lastname: Van Aerssen
authors.forename: G
authors.initials: G
authors.lastname: Ott
authors.forename: A
authors.initials: A
authors.lastname: Thiede
authors.forename: H
authors.initials: H
authors.lastname: Kasper
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology; D007583:Jejunum / Q000098:blood supply* / Q000473:pathology; D008297:Male; D008551:Melena / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D014456:Ulcer / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy