title: Massive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review.
abstract: Bleeding from duodenal varices is reported to be a catastrophic and often fatal event. Most of the cases in the literature involve patients with underlying cirrhosis. However, approximately one quarter of duodenal variceal bleeds is caused by extrahepatic portal hypertension and they represent a unique population given their lack of liver dysfunction. The authors present a case where a 61-year-old male with history of remote crush injury presented with bright red blood per rectum and was found to have bleeding from massive duodenal varices. Injection sclerotherapy with ethanolamine was performed and the patient experienced a favorable outcome with near resolution of his varices on endoscopic follow-up. The authors conclude that sclerotherapy is a reasonable first line therapy and review the literature surrounding the treatment of duodenal varices secondary to extrahepatic portal hypertension.
authors.affiliation: Christopher Steevens, Maisa Abdalla, Vivek Kaul, Shivangi Kothari, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Steevens
authors.affiliation: Christopher Steevens, Maisa Abdalla, Vivek Kaul, Shivangi Kothari, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States.
authors.forename: Maisa
authors.initials: M
authors.lastname: Abdalla
authors.affiliation: Christopher Steevens, Maisa Abdalla, Vivek Kaul, Shivangi Kothari, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States.
authors.forename: Truptesh H
authors.initials: TH
authors.lastname: Kothari
authors.affiliation: Christopher Steevens, Maisa Abdalla, Vivek Kaul, Shivangi Kothari, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kaul
authors.affiliation: Christopher Steevens, Maisa Abdalla, Vivek Kaul, Shivangi Kothari, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States.
authors.forename: Shivangi
authors.initials: S
authors.lastname: Kothari
keywords: Duodenal varices; Extrahepatic portal hypertension; Sclerotherapy