Temel Tuncer, Aktas Abdülvahhap, Ozgenel Safak Meric, Özakyol Aysegül
Department of Gastroenterology, Eskisehir Osmangazi University, Eskisehir, Turkey.
Department of Internal Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
Euroasian J Hepatogastroenterol. 2016 Jul-Dec;6(2):176-178. doi: 10.5005/jp-journals-10018-1194. Epub 2016 Dec 1.
Bleeding from duodenal varices is a rare complication of portal hypertension, occurring in only 0.4% of these patients and is often life-threatening because of the difficulty in diagnosis and treatment. Treatment options include surgical procedures and endoscopic and endovascular treatments. A 48-year-old female cirrhotic patient was admitted to our clinic with upper gastrointestinal (GI) tract bleeding. Endoscopic examination revealed nonbleeding Lm, Cb, RC (+), F3-F3-F2 esophageal and nodular-bleeding-oozing duodenal varices. Esophageal varices were eradicated with band ligation at two sessions. After one session of 2% polydocanol sclerotheraphy, no signs of bleeding were determined. Complete eradication was achieved after five sessions and 1 year apart from the initial treatment duodenal varices were eradicated. Although duodenal varices are rare, they are frequently fatal. There are limited data regarding optimal treatment. Successful treatment depends both on patient factors (hepatic synthetic function, comorbidities, size/location of the varices) and center expertise. Long-term eradication is variable and may depend on the cause and extensiveness of the ectopic varices.
Temel T, Aktas A, Ozgenel SM, Özakyol A. Complete Eradication of Bleeding Duodenal Varices with Endoscopic Polydocanol Sclerotherapy. Euroasian J Hepato-Gastroenterol 2016;6(2):176-178.
十二指肠静脉曲张出血是门静脉高压症的一种罕见并发症,仅发生于0.4%的此类患者中,且由于诊断和治疗困难,常危及生命。治疗选择包括外科手术、内镜和血管内治疗。一名48岁的肝硬化女性患者因上消化道出血入住我院。内镜检查发现有非出血性的Lm、Cb、RC(+)、F3 - F3 - F2级食管静脉曲张以及结节状出血渗血的十二指肠静脉曲张。通过两次套扎术根除了食管静脉曲张。在进行一次2%聚多卡醇硬化治疗后,未发现出血迹象。在五次治疗后实现了完全根除,且在初始治疗一年后根除了十二指肠静脉曲张。尽管十二指肠静脉曲张罕见,但往往是致命的。关于最佳治疗的数据有限。成功的治疗既取决于患者因素(肝脏合成功能、合并症、静脉曲张的大小/位置),也取决于中心的专业水平。长期根除情况不一,可能取决于异位静脉曲张的病因和范围。
Temel T, Aktas A, Ozgenel SM, Özakyol A. 内镜下聚多卡醇硬化治疗完全根除出血性十二指肠静脉曲张. 《欧亚肝脏胃肠病学杂志》2016;6(2):176 - 178.