Endoscopic ligation of bleeding rectal varices

Levine, Jeffrey H.; Tahiri, Abdalla; Banerjee, Bhaskar

doi:10.1016/s0016-5107(93)70067-x

Cited by 49 publications

(24 citation statements)

References 15 publications

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“…It may be useful for temporary hemostasis but rebleeding is a problem [110,111] . However, several cases of successful treatment of rectal varices using EVL have been reported [112,113] .…”

Section: Ectopic Varices Obliterationmentioning

confidence: 99%

Endoscopic Management of Variceal Haemorrhage

Dell’Era

Iannuzzi

Franchis

2015

Journal of Gastroenterology and Hepatology Research

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One of the most important complications of portal hypertension, in the setting of liver cirrhosis or of non-cirrhotic portal hypertension, is upper gastrointestinal bleeding from ruptured gastroesophageal varices and portal hypertensive gastropathy. The management of the acute variceal bleeding is a multidisciplinary process that includes the initial assessment of the patient, effective resuscitation, timely diagnosis, control of bleeding and prevention of early rebleeding and complications such as infection, hepatorenal syndrome, or hepatic encephalopathy. Antibiotic prophylaxis, conservative targets for blood transfusions and combination therapy with vasoactive drugs and endoscopic treatments are the first-line measures in the management of acute variceal bleeding; transjugular intrahepatic portosystemic shunts should be proposed early to high-risk patients or as a rescue therapy for those who fail first-line treatment.

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“…It may be useful for temporary hemostasis but rebleeding is a problem [110,111] . However, several cases of successful treatment of rectal varices using EVL have been reported [112,113] .…”

Section: Ectopic Varices Obliterationmentioning

confidence: 99%

Endoscopic Management of Variceal Haemorrhage

Dell’Era

Iannuzzi

Franchis

2015

Journal of Gastroenterology and Hepatology Research

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“…They described it as a safe and effective therapy for rectal varices. 21 Massive bleeding rarely occurs in rectal varices, but it is often fatal. If rectal varices show risky signs of bleeding, prophylactic therapy should be considered according to the clinical condition of the patient, including liver function.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic evaluation of rectal varices by color Doppler ultrasonography: a case report

et al. 2007

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A 69-year-old man with liver cirrhosis was admitted to our hospital with general fatigue. Colonoscopy revealed risky red color sign-positive enlarged tortuous rectal varices. Endoscopic injection sclerotherapy (EIS) was performed three times weekly using 5% ethanolamine oleate with iopamidol; the total amount of sclerosant was 7 ml. Images of rectal varices and the outflowing vessel from rectal varices were obtained via color Doppler ultrasonography before EIS, and fast Fourier transform analysis showed a continuous flow with a frequency shift of 276.6 Hz. We successfully performed EIS for this patient, having effective varicealography. After EIS, colonoscopy revealed shrinkage of the varices in the rectum, and color Doppler indicated an extreme decrease of blood flow in the rectal varices. In conclusion, color Doppler is a useful noninvasive modality for detecting rectal varices and for evaluating the therapeutic effects of EIS.

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“…Control of a hemorrhagic episode has been documented with endoscopic sclerosant injection [9], band ligation [10], or surgically using underrunning suturing [6]or inferior mesenteric vein ligation [5, 11]. Finally, variceal embolization therapy can be successfully used to control bleeding [12].…”

Section: Discussionmentioning

confidence: 99%

The Long-Term Efficacy of the Intrahepatic Portosystemic Shunt (TIPS) for the Treatment of Bleeding Anorectal Varices in Cirrhosis

Ory¹,

Megevand

Becker

et al. 2001

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Background: In patients with portal hypertension and variceal hemorrhage, the transjugular intrahepatic portosystemic shunt (TIPS) is indicated when drug therapy or endoscopic treatment fails to control bleeding. Ruptured esophageal or gastric varices are the most frequent causes of portal hypertension-related hemorrhage, but anorectal varices may also bleed. Although several case reports have proposed TIPS in this situation, the long-term results of this procedure have not been described. Methods: We report here the case of a 68-year-old patient with decompensated cirrhosis who presented with recurrent hematochezia due to anorectal varices. Results: A successful control of bleeding could be obtained after placement of TIPS. After 3 years of follow-up, rectal bleeding did not recur, the shunt remained primarily patent, and the patient did not present overt hepatic encephalopathy. Conclusion: TIPS procedure should be considered as an effective treatment of recurrent bleeding from anorectal varices in patients with decompensated cirrhosis.

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Endoscopic ligation of bleeding rectal varices

Cited by 49 publications

References 15 publications

Endoscopic Management of Variceal Haemorrhage

Endoscopic Management of Variceal Haemorrhage

Hemodynamic evaluation of rectal varices by color Doppler ultrasonography: a case report

The Long-Term Efficacy of the Intrahepatic Portosystemic Shunt (TIPS) for the Treatment of Bleeding Anorectal Varices in Cirrhosis

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