Jejunal varices with extra hepatic portal vein obstruction: A case report.

Autor: Shrestha BM; Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal. Electronic address: bibekmanstha7@gmail.com., Shrestha S; Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal., Kharel S; Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal. Electronic address: kharel_sanjeev@iom.edu.np., K C A; Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Shrestha S; Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Pradhan S; Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Bhandari RS; Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Jazyk: angličtina
Zdroj: International journal of surgery case reports [Int J Surg Case Rep] 2021 Jun; Vol. 83, pp. 105964. Date of Electronic Publication: 2021 May 12.
DOI: 10.1016/j.ijscr.2021.105964
Abstrakt: Introduction and Importance: Extrahepatic portal vein obstruction (EHPVO) with portal hypertension is rare in children. Intestinal varices as new collaterals accompanying portal hypertension are very rare.
Presentation of Case: We report an unusual case of a 12-year-old boy with EHPVO with gastrointestinal bleeding from ectopic jejunal varices, without any gastroesophageal varices.
Discussion: Portal hypertension is the most common cause of EHPVO. Among various ectopic varices, intestinal varices are found distal to the duodenum and present with complaints of hematochezia, melena, or intraperitoneal bleeding. The diagnosis of the EHPVO is aided by imaging investigations like Doppler ultrasound, computed tomography, or magnetic resonance imaging. A multidisciplinary team including gastroenterologists, interventional radiologists, surgeons, and intensivists is crucial in the management of ectopic varices.
Conclusion: Jejunal varices must be considered in the differential diagnosis of gastrointestinal (GI) hemorrhage in patients with a negative source of bleed on upper and lower GI endoscopy.
(Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE