Document Detail


Clinical characteristics and treatment for patients presenting with bleeding duodenal varices.
MedLine Citation:
PMID:  21175479     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Bleeding from ectopic varices, including duodenal varices, is uncommon, but it can be difficult to manage. The clinical data of patients diagnosed and treated for duodenal varices were reviewed to investigate the strategy for treatment.
METHODS: The present study reviewed the clinical data of 10 patients with duodenal varices (mean age, 58.2 ± 15.6 years) at our associated institutes during the period between January 1996 and December 2008.
RESULTS: Nine patients had duodenal varices located in the second portion, whereas in one case they were located in the duodenal bulbus. The underlying diseases included liver cirrhosis in eight patients, and extrahepatic portal vein obstruction in two patients. The lesions were identified with bleeding from varices in eight of 10 patients. Initial hemostasis was achieved in all eight patients. However, among four patients treated endoscopically only, two patients died from rebleeding from varices and two died from hepatic failure resulting from variceal bleeding. Additional interventional radiology (IVR) was used in three patients and additional surgery was carried out in one case. One patient who was treated with balloon-occluded retrograde transvenous obliteration rebled during IVR and died from bleeding. Two patients who underwent double balloon-occluded embolotherapy and one case who had surgery achieved good clinical outcomes.
CONCLUSIONS: Although endoscopic treatment is useful for initial hemostasis of hemorrhagic duodenal varices, the patients who underwent additional IVR after endoscopic treatment achieved good outcomes.
Authors:
Satoru Kakizaki; Mitsuo Toyoda; Takeshi Ichikawa; Ken Sato; Hitoshi Takagi; Hirotaka Arai; Naondo Sohara; Haruhisa Iizuka; Yasuhiro Onozato; Masatomo Mori
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society     Volume:  22     ISSN:  1443-1661     ISO Abbreviation:  Dig Endosc     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9101419     Medline TA:  Dig Endosc     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  275-81     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Digestive Endoscopy © 2010 Japan Gastroenterological Endoscopy Society.
Affiliation:
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan. kakizaki@showa.gunma-u.ac.jp
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