Enteroscopic identification of ectopic small bowel varices

Cutler, Christopher S.; Rex, Douglas K.; Lehman, Glen A.

doi:10.1016/s0016-5107(95)70202-4

Cited by 19 publications

(12 citation statements)

References 10 publications

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“…No formal recommendation on their optimal treatment can be made because no clinical trials have been made. To date they are treated like EV or GV and the preferred treatment depends mainly on local expertise and location of the varices [97][98][99] .…”

Section: Ectopic Variceal Bleedingmentioning

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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Section: Ectopic Variceal Bleedingmentioning

confidence: 99%

Endoscopic Management of Variceal Haemorrhage

Dell’Era

Iannuzzi

Franchis

2015

Journal of Gastroenterology and Hepatology Research

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“…Varices involving the small intestine are commonly found at anastomotic sites and in adhesions [71]. Patients who present with bleeding jejunal or ileal varices typically have a history of portal hypertension (usually secondary to liver cirrhosis), prior abdominal surgery, and hematochezia without hematemesis [71,72].…”

Section: Jejunal and Ileal Varicesmentioning

confidence: 99%

“…Patients who present with bleeding jejunal or ileal varices typically have a history of portal hypertension (usually secondary to liver cirrhosis), prior abdominal surgery, and hematochezia without hematemesis [71,72]. Jejunal and ileal varices are rare but should be considered in such cases because bleeding from small bowel varices can be life threatening.…”

Section: Jejunal and Ileal Varicesmentioning

confidence: 99%

“…Endoscopy is rarely helpful when bleeding is distal to the duodenum. The increased use of enteroscopy and maintaining a high index of suspicion may make endoscopy more rewarding in finding jejunal varices [71]. Angiography may or may not reveal the bleeding source, but it is most useful when particular attention is paid to the venous phase of the study [72].…”

Section: Jejunal and Ileal Varicesmentioning

confidence: 99%

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Extraesophageal Varices

Kotfila¹,

Trudeau²

1998

Dig Dis

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Esophageal varices are the most common site of variceal bleeding. However, bleeding from varices that are not located in the esophagus may account for up to 30% of all variceal bleeding. Significant varices can occur in the stomach, duodenum, jejunum, ileum, colon, rectum, and biliary tree. They can also occur at the site of a surgical ostomy. These types of varices bleed less commonly than esophageal varices, but they can also be far more difficult to diagnose and treat. The absence of stigmata of recent esophageal variceal bleeding and certain clues in the patient’s history and clinical presentation should raise the clinician’s suspicion of an extraesophageal site of variceal bleeding. Particularly, patients with extrahepatic causes of portal hypertension, cirrhotic patients with a prior history of gastrointestinal surgery, and patients who present with profound bleeding but without hematemesis need to be evaluated further if an obvious site of esophageal variceal bleeding is not seen on initial endoscopy. In this article, we review the features particular to extraesophageal varices as well as the diagnosis and management of bleeding from these varices. We use the term extraesophageal rather than ectopic because the term ectopic varices implies exclusion of both esophageal and gastric varices.

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“…Although the precise incidence remains uncertain, S-B varices are considered to be very rare; the literature includes fewer than 100 cases [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Although rare, a persistent and frustrating, often massive, bleeding remains a major source of clinical morbidity in S-B varices patients.…”

Section: Discussionmentioning

confidence: 99%

Small bowel varices: report of two cases

et al. 1998

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Two cases of small bowel (S-B) varices associated with portal hypertension, one with liver cirrhosis and one with portal thrombus, are reported. Detection of S-B varices has been a challenging task and several invasive diagnostic techniques have been used for this purpose. However, in our cases, color Doppler sonography revealed the S-B varices supplied by the superior mesenteric vein and draining to the iliac (one case) or ovarian vein (other case), which helped to establish an early appropriate diagnostic and treatment plan.

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Enteroscopic identification of ectopic small bowel varices

Cited by 19 publications

References 10 publications

Endoscopic Management of Variceal Haemorrhage

Endoscopic Management of Variceal Haemorrhage

Extraesophageal Varices

Small bowel varices: report of two cases

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