Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2017 Dec 27;9(12):288-292.
doi: 10.4240/wjgs.v9.i12.288.

Ectopic gastrointestinal variceal bleeding with portal hypertension

Keita Minowa  1 , Shuhei Komatsu  1 , Kenichiro Takashina  1 , Sachie Tanaka  1 , Tatsuya Kumano  1 , Kenichiro Imura  1 , Katsumi Shimomura  1 , Jun Ikeda  1 , Fumihiro Taniguchi  1 , Yasuo Ueshima  1 , Tecchuu Lee  1 , Eito Ikeda  1 , Eigo Otsuji  2 , Yasuhiro Shioaki  1
Affiliations
Case Reports

Ectopic gastrointestinal variceal bleeding with portal hypertension

Keita Minowa et al. World J Gastrointest Surg. .

Abstract

Massive gastrointestinal bleeding from gastrointestinal varices is one of the most serious complications in patients with portal hypertension. However, if no bleeding point can be detected by endoscopy in the predilection sites of gastrointestinal varices, such as the esophagus and stomach, ectopic gastrointestinal variceal bleeding should be considered as a differential diagnosis. Herein, we report a case of ectopic ileal variceal bleeding in a 57-year-old woman, which was successfully diagnosed by multi-detector row CT (MDCT) and angiography and treated by segmental ileum resection. To date, there have been no consensus for the treatment of ectopic ileal variceal bleeding. This review was designed to clarify the clinical characteristics of patients with ectopic ileal variceal and discuss possible treatment strategies. From the PubMed database and our own database, we reviewed 21 consecutive cases of ileal variceal bleeding diagnosed from 1982 to 2017. MDCT and angiography is useful for the rapid examination and surgical resection of an affected lesion and is a safe and effective treatment strategy to avoid further bleeding.

Keywords: Ectopic gastrointestinal bleeding; Ileal varix; Portal hypertension.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: We have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Ileal varices (arrow) were detected using multi-detector row CT and angiography and were resected by laparotomy.
Figure 2
Figure 2
The management algorythm for massive gastrointestinal bleeding in patients with portal hypertension. MDCT: Multi-detector raw computed tomography; TIPS: Transjugular intrahepatic portosystemic shunt; BRTO: Baloon occluded retrograde transvenous obliteration.
See this image and copyright information in PMC

References

    1. Lebrec D, Benhamou JP. Ectopic varices in portal hypertension. Clin Gastroenterol. 1985;14:105–121. - PubMed
    1. Norton ID, Andrews JC, Kamath PS. Management of ectopic varices. Hepatology. 1998;28:1154–1158. - PubMed
    1. De Palma GD, Rega M, Masone S, Persico F, Siciliano S, Patrone F, Matantuono L, Persico G. Mucosal abnormalities of the small bowel in patients with cirrhosis and portal hypertension: a capsule endoscopy study. Gastrointest Endosc. 2005;62:529–534. - PubMed
    1. Yuki N, Kubo M, Noro Y, Kasahara A, Hayashi N, Fusamoto H, Ito T, Kamada T. Jejunal varices as a cause of massive gastrointestinal bleeding. Am J Gastroenterol. 1992;87:514–517. - PubMed
    1. Joo YE, Kim HS, Choi SK, Rew JS, Kim HR, Kim SJ. Massive gastrointestinal bleeding from jejunal varices. J Gastroenterol. 2000;35:775–778. - PubMed

Publication types

LinkOut - more resources