Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Institute of Liver Studies, King's College Hospital, London, UK.
Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Institute of Liver Studies, King's College Hospital, London, UK.
Lancet Gastroenterol Hepatol. 2023 Nov;8(11):1046-1056. doi: 10.1016/S2468-1253(23)00209-1. Epub 2023 Sep 9.
Ectopic variceal bleeding is a rare cause of gastrointestinal bleeding that can occur in settings of cirrhotic and non-cirrhotic portal hypertension and is characterised by its development at locations remote from the oesophagus and stomach. Ectopic varices can be difficult to identify and access, and, although a relatively uncommon cause of portal hypertensive bleeding, can represent a difficult diagnostic and therapeutic challenge associated with considerable mortality. Low incidence and variance in variceal anatomy preclude large randomised controlled trials, and clinical practice is based on experience from case reports, case series, and specialist centre expertise. Optimisation of survival outcomes relies on understanding a patient's portal venous anatomy and functional hepatic reserve to guide timely and targeted endoscopic and endovascular interventions to facilitate the rapid control of ectopic variceal bleeding.
异位静脉曲张出血是一种罕见的胃肠道出血原因，可发生在肝硬化和非肝硬化门静脉高压症的情况下，其特征是在远离食管和胃的部位发展。异位静脉曲张可能难以识别和处理，虽然是门静脉高压性出血的相对少见原因，但可能是一个具有相当死亡率的诊断和治疗挑战。静脉曲张解剖结构的发生率低且变化大，排除了大规模随机对照试验，临床实践基于病例报告、病例系列和专业中心专业知识的经验。优化生存结果依赖于了解患者的门静脉解剖结构和功能性肝储备，以指导及时和有针对性的内镜和血管内干预，以快速控制异位静脉曲张出血。
