Department of Radiology, University Hospitals, Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
Department of Medicine, University Hospitals, Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Abdom Radiol (NY). 2021 Mar;46(3):1163-1170. doi: 10.1007/s00261-020-02746-6. Epub 2020 Sep 17.
In the setting of portal hypertension, intractable bleeding from anorectal varices is a rare occurrence. In this review, clinical presentation and management of this dilemma are presented in a case-based fashion. Bleeding may occur in the absence of prior history of cirrhosis or gastroesophageal varices and measurement of hepatic venous pressure gradient and liver biopsy could help to establish the diagnosis. Successful treatment outcome necessitates tailoring treatment to the patient's anatomy and imaging findings. A multidisciplinary algorithmic approach is also proposed to aid clinicians in this regard.
在门静脉高压症的背景下,直肠静脉曲张出血难以控制是一种罕见的情况。在本综述中,我们以病例为基础的方式介绍了这种困境的临床表现和处理方法。出血可能发生在没有既往肝硬化或胃食管静脉曲张病史的情况下,肝静脉压力梯度和肝活检的测量有助于明确诊断。成功的治疗结果需要根据患者的解剖和影像学发现来定制治疗方案。我们还提出了一种多学科的算法方法,以帮助临床医生在这方面。