Jejunal variceal bleeding after esophageal transection in a patient with idiopathic portal hypertension.
This report describes a 38-year-old man with massive gastrointestinal bleeding from jejunal varices. He had been previously diagnosed to have idiopathic portal hypertension and esophageal varices, and had undergone an esophageal transection 8 years earlier. The pre-operative diagnosis was a suspected hemorrhage from the small intestine as visualized by 99mTc-HSAD scintigraphy (technetium 99m-labeled human serum albumin D-type) and was not considered to be repeated massive lower GI tract bleeding. An exploratory laparotomy was performed, and intra-operative endoscopy revealed active bleeding from the jejunal varices. A partial resection of the small intestine resulted in a complete resolution of the bleeding. A review of the literature thereafter disclosed twelve previously reported cases of jejunal variceal bleeding.
Migou
S
S
Department of Surgery II, Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hashizume
M
M
Tsugawa
K
K
Kishihara
F
F
Kawanaka
H
H
Ohta
M
M
Tanoue
K
K
Kuroiwa
T
T
Kawamoto
K
K
Sugimachi
K
K
D000328:Adult; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007583:Jejunum / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D013997:Time Factors; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000209:etiology*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin