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Ectopic variceal bleeding after hepatobiliary surgery: A case report

RATIONALE: Jejunal varices are rare in portal hypertension and are often difficult to diagnose and treat. Herein, we present a case of gastrointestinal bleeding due to jejunal varices after hepatobiliary surgery. PATIENT CONCERNS: A 69-year-old man presented with recurrent massive gastrointestinal b...

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Autores principales: Tai, Yang, Tong, Huan, Wei, Bo, Wu, Hao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939183/
https://www.ncbi.nlm.nih.gov/pubmed/33655966
http://dx.doi.org/10.1097/MD.0000000000024975
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author Tai, Yang
Tong, Huan
Wei, Bo
Wu, Hao
author_facet Tai, Yang
Tong, Huan
Wei, Bo
Wu, Hao
author_sort Tai, Yang
collection PubMed
description RATIONALE: Jejunal varices are rare in portal hypertension and are often difficult to diagnose and treat. Herein, we present a case of gastrointestinal bleeding due to jejunal varices after hepatobiliary surgery. PATIENT CONCERNS: A 69-year-old man presented with recurrent massive gastrointestinal bleeding. He underwent partial right hepatectomy and cholangiojejunostomy 2 years prior to the first onset of bleeding. Two sessions of endoscopic vessel ligation for esophageal varices were performed afterwards, and hematemesis resolved completely, but massive melena still recurred during the following 5 years. DIAGNOSIS: The patient was diagnosed with jejunal varices caused by portal venous stenosis after hepatobiliary surgery. INTERVENTION: Portal venous angioplasty using balloon dilation and stent implantation was performed. OUTCOMES: After the intervention procedure, the patient did not experience any onset of gastrointestinal bleeding during follow-up. LESSONS: Hepatopancreatobiliary could lead to the formation of jejunal varices. The combined use of capsule endoscopy, contrast-enhanced computed tomography, and sometimes portal venography is a promising strategy to search for jejunal varices. Transcatheter angioplasty appears to be a safe and effective method for treatment of jejunal varices in certain appropriate cases.
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spelling pubmed-79391832021-03-08 Ectopic variceal bleeding after hepatobiliary surgery: A case report Tai, Yang Tong, Huan Wei, Bo Wu, Hao Medicine (Baltimore) 4500 RATIONALE: Jejunal varices are rare in portal hypertension and are often difficult to diagnose and treat. Herein, we present a case of gastrointestinal bleeding due to jejunal varices after hepatobiliary surgery. PATIENT CONCERNS: A 69-year-old man presented with recurrent massive gastrointestinal bleeding. He underwent partial right hepatectomy and cholangiojejunostomy 2 years prior to the first onset of bleeding. Two sessions of endoscopic vessel ligation for esophageal varices were performed afterwards, and hematemesis resolved completely, but massive melena still recurred during the following 5 years. DIAGNOSIS: The patient was diagnosed with jejunal varices caused by portal venous stenosis after hepatobiliary surgery. INTERVENTION: Portal venous angioplasty using balloon dilation and stent implantation was performed. OUTCOMES: After the intervention procedure, the patient did not experience any onset of gastrointestinal bleeding during follow-up. LESSONS: Hepatopancreatobiliary could lead to the formation of jejunal varices. The combined use of capsule endoscopy, contrast-enhanced computed tomography, and sometimes portal venography is a promising strategy to search for jejunal varices. Transcatheter angioplasty appears to be a safe and effective method for treatment of jejunal varices in certain appropriate cases. Lippincott Williams & Wilkins 2021-03-05 /pmc/articles/PMC7939183/ /pubmed/33655966 http://dx.doi.org/10.1097/MD.0000000000024975 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 4500
Tai, Yang
Tong, Huan
Wei, Bo
Wu, Hao
Ectopic variceal bleeding after hepatobiliary surgery: A case report
title Ectopic variceal bleeding after hepatobiliary surgery: A case report
title_full Ectopic variceal bleeding after hepatobiliary surgery: A case report
title_fullStr Ectopic variceal bleeding after hepatobiliary surgery: A case report
title_full_unstemmed Ectopic variceal bleeding after hepatobiliary surgery: A case report
title_short Ectopic variceal bleeding after hepatobiliary surgery: A case report
title_sort ectopic variceal bleeding after hepatobiliary surgery: a case report
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939183/
https://www.ncbi.nlm.nih.gov/pubmed/33655966
http://dx.doi.org/10.1097/MD.0000000000024975
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