Farooqi Amer Rehman, Sunderraj Lawrence
Department of Gastroenterology, Bedford General Hospital, UK.
University Hospital Wales, Heath Park Cardiff, UK.
J Ayub Med Coll Abbottabad. 2017 Apr-Jun;29(2):340-343.
Duodenal variceal bleeding is an uncommon cause of gastrointestinal bleeding. Treatment strategies are reliant on case reports and case series with new developments in interventional treatment modalities including endoscopic therapy, radiological intervention, and surgery. Endoscopic treatment includes injection sclerotherapy using various agents, banding of varices and clipping of varices. Interventional radiological procedures include Transjugular Intrahepatic porto-systemic shunt (TIPSS), and Balloon- Occluded Retrograde Transvenous Obliteration (BRTO). Surgical treatment could be suture ligation of varices or gastro-duodenectomy. In this article, a case report of upper gastrointestinal bleed, and management of duodenal varices is described, with review of the literature to offer optimum modern era treatment to these high risk gastrointestinal bleeds.
十二指肠静脉曲张出血是胃肠道出血的一种罕见原因。治疗策略依赖于病例报告和病例系列，以及介入治疗方式的新进展，包括内镜治疗、放射介入和手术。内镜治疗包括使用各种药物的注射硬化疗法、静脉曲张套扎术和静脉曲张夹闭术。介入放射学程序包括经颈静脉肝内门体分流术（TIPSS）和球囊闭塞逆行静脉栓塞术（BRTO）。手术治疗可以是静脉曲张缝扎术或胃十二指肠切除术。本文描述了一例上消化道出血病例及十二指肠静脉曲张的处理，并回顾文献以为这些高危胃肠道出血提供最佳的现代治疗方法。
