Malik Ahsan, Junglee Naushad, Khan Anwar, Sutton Jonathon, Gasem Jaber, Ahmed Waqar
Department of Gastroenterology, Ysbyty Gwynedd, Bangor, UK.
BMJ Case Rep. 2011 May 24;2011:bcr0220113913. doi: 10.1136/bcr.02.2011.3913.
Duodenal varices are a rare complication of portal hypertension secondary to liver cirrhosis. Compared to oesophageal varices, they bleed less often but are also more difficult to diagnose and treat. There is no established treatment for bleeding duodenal varices and different treatment strategies have been employed with variable results. The authors present a case of 52-year-old male who was admitted with melaena. Upper gastrointestinal endoscopy was performed which identified bleeding varices in the second part of duodenum. The varices were injected with cyanoacrylate and the outcome was favourable. Subsequent endoscopies showed complete resolution of the varices. The authors conclude that cyanoacrylate injection is an effective first-line treatment for bleeding duodenal varices.
十二指肠静脉曲张是肝硬化继发门静脉高压的一种罕见并发症。与食管静脉曲张相比，十二指肠静脉曲张出血较少见，但诊断和治疗也更困难。目前尚无针对出血性十二指肠静脉曲张的确立治疗方法，已采用不同的治疗策略，效果各异。作者报告了一例52岁男性因黑便入院的病例。进行了上消化道内镜检查，发现十二指肠第二部有出血性静脉曲张。用氰基丙烯酸酯对静脉曲张进行了注射，结果良好。随后的内镜检查显示静脉曲张完全消退。作者得出结论，氰基丙烯酸酯注射是治疗出血性十二指肠静脉曲张的一种有效的一线治疗方法。
