Ohs Zachary, Jones Matthew, Sharma Neil, Loveridge Kristian
Interventional Radiology, Detroit Medical Center, Detroit, USA.
Cureus. 2021 Sep 23;13(9):e18209. doi: 10.7759/cureus.18209. eCollection 2021 Sep.
Varices secondary to portal hypertension in the setting of liver cirrhosis typically occur in the gastroesophageal region. Management guidelines for bleeding gastroesophageal varices are well established in the literature. Ectopic varices that occur outside of this typical location are an uncommon complication of portal hypertension. Rarely, these varices can result in life-threatening hemorrhage. Management guidelines of ectopic variceal bleeds are not yet standardized as cases are rare and treatment approach in the literature has historically varied. We present an interesting case of a 37-year-old patient with alcoholic liver disease and cirrhosis who developed spontaneous hemorrhage and shock from bleeding ectopic varices. This report exemplifies how coil embolization via a percutaneous transhepatic approach can be used to manage ectopic variceal bleeds in the setting of hemorrhagic shock.
肝硬化背景下门静脉高压继发的静脉曲张通常发生在胃食管区域。关于出血性胃食管静脉曲张的管理指南在文献中已有充分确立。发生在这个典型位置之外的异位静脉曲张是门静脉高压的一种罕见并发症。这些静脉曲张很少会导致危及生命的出血。由于病例罕见且文献中的治疗方法历来各不相同，异位静脉曲张出血的管理指南尚未标准化。我们报告了一例有趣的病例，一名37岁患有酒精性肝病和肝硬化的患者，因异位静脉曲张出血而发生自发性出血和休克。本报告举例说明了经皮经肝途径的线圈栓塞如何可用于在出血性休克情况下管理异位静脉曲张出血。
