| Autor: |
Larson, John V., Bartholomew, David M., Steensma, Elizabeth A., Burke, Leandra H., Ebersole, John D., Miller, Lisa A. |
| Předmět: |
|
| Zdroj: |
Journal of Surgical Radiology; Oct2012, Vol. 3 Issue 4, p230-235, 6p, 1 Color Photograph, 2 Black and White Photographs |
| Abstrakt: |
Overview Duodenal varices are an unexpected source of upper gastrointestinal hemorrhage, and are associated with a high mortality. The prevalence of ectopic variceal bleeding accounts for 2-5% of all variceal bleeding; of this, only 17% of ectopic variceal bleeding occurs in the duodenum1. Diagnosis is difficult, and insufficient evidence exists to demonstrate the best treatment option when hemorrhage occurs. We report a case of a 69 year old male with a history of chronic alcoholism who presented to the emergency department with nausea, vomiting, and several episodes of hematochezia containing bright red blood and clot material. Diagnostic workup in the ER included multi-slice helical computed tomography (CT) with multiplanar reconstruction, and revealed a network of large tortuous blood vessels running near the second portion of the duodenum between the inferior vena cava and portal vein. The patient was emergently treated with endoscopic therapy and clipping of the vessel. This failed, and he was subsequently taken to the operating room for suture ligation of the bleeding duodenal varices. Our case is unique in that the suspected source of bleeding was detected by multi-slice helical CT with multiplanar reconstruction. It serves to provide further evidence of the usefulness of multi-detector helical CT with multiplanar reconstruction in detecting ectopic varices, and reminds us that although uncommon, ectopic varices should be considered in cases where an upper gastrointestinal bleeding source is not clearly identifiable in patients with known liver disease. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
