Diagnosis and management of ectopic varices

Akhter, Nabeel; Haskal, Ziv J.

doi:10.1016/j.gii.2012.08.001

Cited by 56 publications

(79 citation statements)

References 81 publications

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“…Ectopic varices can occur in portal hypertension and in the absence of portal hypertension. In the absence of portal hypertension etiology of ectopic varices caused by congenital anomalous portosystemic anastomoses, abnormal vessel structures, arteriovenous fistulae, rare familial conditions, or related to thromboses 2 This case report demonstrate the approach for obscure overt gastrointestinal bleeding and management of ectopic varices.…”

Section: Introductionmentioning

confidence: 84%

Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation

Maulahela

Renaldi

Syam

2020

InaJGHE

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Section: Introductionmentioning

confidence: 84%

Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation

Maulahela

Renaldi

Syam

2020

InaJGHE

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“…Ectopic varices are venous collaterals occurring anywhere in the abdomen except in the gastroesophageal region and represent up to 5% of all variceal bleeding [1,2]. There is considerable heterogeneity in the epidemiology of ectopic varices because of the modality of detection, etiology of portal hypertension, and significant interobserver variability [3].…”

Section: Discussionmentioning

confidence: 99%

“…There are no randomized trials or set guidelines that dictate the management of bleeding ectopic varices [3]. The goal of treatment is to stop acute bleeding as soon as possible.…”

Section: Discussionmentioning

confidence: 99%

Rectal ectopic variceal bleeding during liver transplantation -A case report-

et al. 2017

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Portal hypertension can lead to development of new veins, called collateral vessels in the esophagus, stomach, abdominal wall, rectum and so on. In particular, collateral vessels located in other site than the gastroesophageal region are defined as ectopic varices. These varices are fragile and can rupture easily, resulting in a large amount of blood loss that may become serious and occasionally result in death. We experienced a case of massive rectal variceal bleeding after cross-clamping of the inferior vena cava and hepatic portal vein during the living donor liver transplantation in patients who had no history of rectal variceal bleeding. Our case suggests that acute intraoperative hemorrhage from an ectopic varix should be a consideration before liver transplantation.

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“…In addition, hepatic portal blood flow and portal pressures have been shown to increase after BRTO. This may improve liver function (50% of patients had an improvement in Child-Pugh score in one study), but can worsen the size of varices at other sites (potentially increasing the risk of bleeding) and may exacerbate ascites [81][82][83][84]. Hepatic encephalopathy may also improve following BRTO, but whether this beneficial effect is sustained long-term remains unknown [83].…”

Section: Brtomentioning

confidence: 99%

The Management of Bleeding from Anorectal Varices

Robertson

Thompson

Hayes

2017

Curr Hepatology Rep

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Purpose of Review The purpose of this review is to summarize available strategies for the diagnosis and management of bleeding anorectal varices. Recent Findings Interventional radiological procedures, including TIPS, BRTO and/or embolization, have been established as efficacious treatments, particularly in the setting of treatment failure. Summary Anorectal varices are prevalent in patients with portal hypertension. Acute bleeding is uncommon, but can be massive and life-threatening. Anorectal varices should be considered as a differential diagnosis in any patient with cirrhosis or portal hypertension who presents with lower gastrointestinal bleeding. No evidence-based guidelines exist to guide the management of bleeding anorectal varices, which typically requires a multidisciplinary team of endoscopists, hepatologists, surgeons and interventional radiologists. Administration of prophylactic antibiotics and vasoactive therapy is recommended based on efficacy in bleeding oesophageal varices. Urgent endoscopy should be performed in all patients. Endoscopic sclerotherapy has the greatest body of evidence and should be considered the first-line therapy; efficacy and safety may be increased if this is performed with endoscopic ultrasound. Endoscopic banding or obturation are alternative first-line treatments; all methods offer a technically simple and efficacious method of achieving haemostasis, and local expertise will determine which procedure is employed.

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Diagnosis and management of ectopic varices

Cited by 56 publications

References 81 publications

Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation

Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation

Rectal ectopic variceal bleeding during liver transplantation -A case report-

The Management of Bleeding from Anorectal Varices

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