Downhill Esophageal Varices Associated With Central Venous Catheter-Related Thrombosis Managed With Endoscopic and Surgical Therapy.
Downhill esophageal varices are a rare cause of upper gastrointestinal hemorrhage. We present a case of downhill variceal bleeding due to superior vena cava thrombosis resulting from a prior central venous catheter. The patient was managed with endoscopic band ligation and later with surgical axillary vein to right atrium bypass grafting. Successful long-term resolution of varices was achieved at 1 year of follow-up. This is the longest follow-up described for combined endoscopic and surgical management in the existing literature for catheter-associated downhill varices.
Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, North Shore Long Island Jewish Health System, New Hyde Park, NY.
Joshua C
JC
Berkowitz
Department of Medicine, Division of Nephrology, New York University Langone Medical Center, New York, NY.
Sushma
S
Bhusal
Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, North Shore Long Island Jewish Health System, New Hyde Park, NY.
Deepak
D
Desai
Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, North Shore Long Island Jewish Health System, New Hyde Park, NY.
Maurice A
MA
Cerulli
Department of Medicine, Division of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, North Shore Long Island Jewish Health System, New Hyde Park, NY.
Sumant
S
Inamdar