title: Bleeding duodenal varices after gastroesophageal varices ligation: a case report.
abstract: 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.
authors.affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Wu
authors.forename: Liang-Yen
authors.initials: LY
authors.lastname: Wang
authors.forename: Fang-Jung
authors.initials: FJ
authors.lastname: Yu
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Wang
authors.forename: Shinn-Cherng
authors.initials: SC
authors.lastname: Chen
authors.forename: Wan-Long
authors.initials: WL
authors.lastname: Chuang
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chang
mesh_terms: 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