Document Detail

Duodenal dearterialization and stapling for severe hemorrhage from duodenal varices with portal vein thrombosis.
MedLine Citation:
PMID:  15701491     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hemorrhage from duodenal varices is a rare but frequently fatal cause of gastrointestinal bleeding. Portal vein thrombosis may worsen the bleeding and prevent access for reduction of variceal pressure. METHODS: A technique to control bleeding and reduce inflow pressure to the varices is described. It includes ligation of the gastroduodenal and splenic arteries, splenectomy, stapling of the duodenum, and gastroenterostomy. RESULTS: Three patients, hemodynamically unstable from duodenal hemorrhage, underwent the procedure. No further bleeding was encountered. One patient died of fungal sepsis and liver failure, but 2 are alive without further problems 21 and 24 months later. CONCLUSIONS: Reduction in arterial inflow, direct variceal ligation, reversal of hypersplenism, and food stream diversion are elements of this procedure that may have contributed the control of severe hemorrhage from duodenal varices associated with portal vein thrombosis.
Vivian C McAlister; Noha A Al-Saleh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  189     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-09     Completed Date:  2005-03-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-52     Citation Subset:  AIM; IM    
Department of Surgery, 4TU-44, University Hospital, London, Ontario, Canada N6A 5A5.
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MeSH Terms
Duodenum / blood supply*,  surgery*
Erythrocyte Transfusion
Gastrointestinal Hemorrhage / etiology*,  surgery*
Portal Vein*
Splenic Artery / surgery
Surgical Stapling
Varicose Veins / complications*
Venous Thrombosis / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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