Bejarano Rengifo Janeth, Roa Ballestas Paola
Fellow de Gastroenterología y endoscopia digestiva, Pontificia Universidad Javeriana. Bogotá, Colombia.
Unidad de Gastroenterología y Endoscopia Digestiva, Hospital Universitario San Ignacio. Bogotá, Colombia.
Rev Gastroenterol Peru. 2020 Jul-Sep;40(3):270-273.
Small bowel varices are usually associated with portal hypertension. Ectopic varices caused by isolated chronic superior mesenteric vein thrombosis are exceedingly rare. Gastrointestinal bleeding secondary to these represents a diagnostic challenge, given the low prevalence and clinical suspicion, and therapeutic dilemma due to the limited scientific evidence available regarding treatment options. We present the case of a 56-year-old man with gastrointestinal bleeding from jejunal varices due to chronic superior mesenteric vein thrombosis, associated with thrombophilia; diagnosed by video capsule endoscopic (VCE) and computed tomography enterography (CTE), with no possibility of endoscopic or radiological management given the extensive involvement, who underwent successful surgery.
小肠静脉曲张通常与门静脉高压相关。由孤立的慢性肠系膜上静脉血栓形成引起的异位静脉曲张极为罕见。鉴于其低患病率和临床怀疑，继发于这些情况的胃肠道出血带来了诊断挑战，并且由于关于治疗选择的科学证据有限，也存在治疗困境。我们报告一例56岁男性患者，因慢性肠系膜上静脉血栓形成合并易栓症导致空肠静脉曲张并出现胃肠道出血；通过视频胶囊内镜（VCE）和计算机断层扫描小肠造影（CTE）确诊，鉴于病变广泛，无法进行内镜或放射学处理，该患者接受手术并取得成功。
