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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Rosa, Luis Ferreira, Alexandre Oliveira Sousa, Helena Tavares Brito, Jorge |
| Description | Author Affiliation: Ferreira AO ( Department of Gastroenterology and Hepatology, Centro Hospitalar Barlavento Algarvio, Portimão, Portugal. alex.fsof@gmail.com) |
| Abstract | Upper gastrointestinal bleeding from variceal origin is a frequent complication in the cirrhotic population. Duodenal variceal haemorrhage, however, is infrequent and the endoscopic management of such lesions is not straightforward. Non-endoscopic options include vasoactive drugs, transjugular intrahepatic portosystemic shunt (TIPS), transvenous obliteration and surgery as rescue therapy. We present a patient with Child-Pugh A hepatitis C virus-cirrhosis with acute bleeding from a duodenal varix. It was managed with elastic band ligation but late rebleeding occurred after 6 weeks. Gastroduodenoscopy revealed active bleeding from the ligation eschar. Band ligation and sclerosis were attempted but unsuccessful. Terlipressin was started and the patient referred for TIPS. Surprisingly, angiography showed a normal hepatic vein pressure gradient; therefore, TIPS was not performed. Haemorrhage ceased with medical treatment alone. The patient remained stable and was discharged after 10 days, being currently under evaluation for hepatitis C therapy. |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Volume Number | 2013 |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Duodenum Blood Supply Gastrointestinal Hemorrhage Etiology Hepatitis C, Chronic Complications Liver Cirrhosis Varicose Veins Drug Therapy Ligation Lypressin Analogs & Derivatives Therapeutic Use Tomography, X-Ray Computed Vasoconstrictor Agents Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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