Bleeding duodenal varices after gastroesophageal varices ligation: a case report.
Duodenal varices are rarely occurring sites of hemorrhage in patients with portal hypertension, and such hemorrhaging can be a life-threatening event. We report the case of a 58-year-old woman with cirrhosis who presented with melena after successful ligation of gastroesophageal varices 1 week earlier. Upper gastrointestinal endoscopy revealed bleeding duodenal varices in the second portion of the duodenum, which was considered to be the source of the bleeding. Endoscopic injection sclerotherapy with histoacryl and lipiodol achieved successful hemostasis. Nonetheless, the sclerosant spread to the lungs via a portosystemic shunt, causing a pulmonary embolism. This is a rare complication seldom reported in the world literature.
Wu
Wen-Chih
WC
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Wang
Liang-Yen
LY
Yu
Fang-Jung
FJ
Wang
Wen-Ming
WM
Chen
Shinn-Cherng
SC
Chuang
Wan-Long
WL
Chang
Wen-Yu
WY
D004386:Duodenum / Q000098:blood supply*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008026:Ligation; D008875:Middle Aged; D015911:Sclerotherapy; D014648:Varicose Veins / Q000209:etiology* / Q000628:therapy