PDF(Pubmed)
Abstract：
Ectopic variceal bleeding is an uncommon cause of gastrointestinal bleeding and carries a high mortality. Management depends on provider comfort and resource availability as treatment guidelines are lacking due to the infrequent occurrence of bleeding ectopic varices. We present a case of a middle-aged woman who presented with melena and anemia requiring transfusion. She was diagnosed with cirrhosis, and computed tomography of the abdomen revealed active bleeding at the proximal duodenum. She underwent emergent esophagogastroduodenoscopy, which showed actively bleeding duodenal varices secondary to portosystemic shunt from portal hypertension. Endoscopic hemostasis was achieved with variceal band ligation, a useful modality when alternative methods of emergent variceal management are unavailable. Given the risk of recurrent bleeding, the patient underwent embolization of varices by interventional radiology.
摘要：
异位静脉曲张破裂出血是胃肠道出血的罕见原因，死亡率高。管理取决于提供者的舒适度和资源的可用性，因为由于很少发生出血性异位静脉曲张而缺乏治疗指南。我们介绍了一例中年妇女，该妇女患有黑便和贫血，需要输血。她被诊断为肝硬化,腹部计算机断层扫描显示十二指肠近端活动性出血。她接受了紧急食管胃十二指肠镜检查，显示门静脉高压症继发于门体分流术的十二指肠静脉曲张出血活跃。通过静脉曲张束带结扎术实现内镜止血，当没有其他紧急静脉曲张管理方法时，这是一种有用的方式。鉴于复发性出血的风险，患者通过介入放射学进行静脉曲张栓塞。
