Duodenal Variceal Rupture during Atezolizumab and Bevacizumab Treatment for Hepatocellular Carcinoma

Duodenal varices are detected infrequently, and their rupture is very rare. We encountered an 87-year-old man who developed duodenal varices rupture during chemotherapy with atezolizumab and bevacizumab (ATZ/BV) for hepatocellular carcinoma. We identified massive bleeding of a ruptured varix in the...

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Detalles Bibliográficos
Autores principales: Tsuruoka, Mio, Inoue, Jun, Ouchi, Keishi, Uno, Kaname, Itami, Hideaki, Ninomiya, Masashi, Iwata, Tomoaki, Sano, Akitoshi, Sato, Kosuke, Onuki, Masazumi, Sawahashi, Satoko, Koike, Tomoyuki, Masamune, Atsushi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10258098/
https://www.ncbi.nlm.nih.gov/pubmed/36198602
http://dx.doi.org/10.2169/internalmedicine.0629-22
Descripción
Sumario:Duodenal varices are detected infrequently, and their rupture is very rare. We encountered an 87-year-old man who developed duodenal varices rupture during chemotherapy with atezolizumab and bevacizumab (ATZ/BV) for hepatocellular carcinoma. We identified massive bleeding of a ruptured varix in the horizontal portion of the duodenum with emergency esophagogastroduodenoscopy (EGD). Successful hemostasis was achieved by endoscopic injection sclerotherapy with Histoacryl. Although ATZ/BV can cause esophageal varices rupture, there have been no cases of duodenal varices rupture. We should take care to check the duodenal varices as well as esophagogastric varices before ATZ/BV treatment.

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