Gastric, Intestinal, and Gallbladder Varices

Salam, Atef A.; Goldman, Martin E.; Smith, David C.; Hill, H W

doi:10.1097/00007611-197904000-00010

Cited by 38 publications

(8 citation statements)

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“…We justify this report based on the unusual source of the hematochezia presented by our patient and the surgical procedure employed [4,5,10,[26][27][28][29][30]. This is only the sixth reported case in the English literature in which varices located in a Roux en Y choledochojejunostomy were the cause of severe hematochezia, and the first case treated by subtotal splenectomy and central splenorenal shunt [7,[30][31][32].…”

Section: Discussionmentioning

confidence: 76%

“…Sustained portal hypertension leads to variceal rupture and GI bleeding, which is more common from varices of the esophagus and the stomach [4,5,10,30]. On the other hand, it has been postulated that adhesions are a key factor in the formation of the majority of small bowel varices in portal hypertension [5,7,10,26,27,30].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of gastrointestinal bleeding (GI) bleeding from ectopic varices is low, ranging from 1 to 5% [4,5]. Enterostomies are the most frequently affected site of nongastroesophageal variceal bleeding [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Subtotal Splenectomy and Central Splenorenal Shunt for Treatment of Bleeding from Roux En Y Jejunal Loop Varices Secondary to Portal Hypertension

2007

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Subtotal Splenectomy and Central Splenorenal Shunt for Treatment of Bleeding from Roux En Y Jejunal Loop Varices Secondary to Portal Hypertension

2007

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“…These corresponded to the impressions on the CBD seen at ERCP. The patient was subsequently proven to have carcinoma of the pancreas.Varicose veins of the esophagus, stomach, duodenum, and gallbladder have been well described [1]. Varicosities of the common bile duct are less well known.…”

mentioning

confidence: 99%

“…Varicose veins of the esophagus, stomach, duodenum, and gallbladder have been well described [1]. Varicosities of the common bile duct are less well known.…”

mentioning

confidence: 99%

Radiographic demonstration of common bile duct varices

Williams

Burnett

Mazer

1982

Gastrointest Radiol

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Varicose veins may occur along the course of the common bile duct in patients with extrahepatic obstruction of the portal vein. These may cause partial biliary obstruction or excessive bleeding during biliary surgery. The cholangiographic appearance of choledochal varices is described.Key words: Biliary tract, varices -Portal hypertension, angiography. enlargement of the pancreas. ERCP demonstrated an irregular stricture in the body of the pancreas suspicious for malignancy. The pancreatic tail was not filled. The distal CBD was also visualized ( Fig. 1) and showed multiple smooth extrinsic impressions along the CBD which were felt to represent varicose venous collaterals. Celiac and superior mesenteric angiography ( Fig. 2) demonstrated complete occlusion of the splenic and distal portal veins. Extensive collateral veins were visualized in the region of the hepatoduodenal ligament along the course of the CBD. These corresponded to the impressions on the CBD seen at ERCP. The patient was subsequently proven to have carcinoma of the pancreas.Varicose veins of the esophagus, stomach, duodenum, and gallbladder have been well described [1]. Varicosities of the common bile duct are less well known. Following extrahepatic obstruction of the portal vein, hepatopetal collaterals may develop within the hepatoduodenal ligament around the common bile duct. The cholangiographic appearance of these choledochal varices has not been previously described. This case report demonstrates the appearance of common bile duct (CBD) varices visualized at endoscopic retrograde cholangiopancreatography (ERCP). Case ReportA 58-year-old woman was referred for evaluation of weight loss, diarrhea, abdominal distention, and abdominal pain radiating to the back. Four months prior to the present admission she had undergone diagnostic laparotomy which revealed chronic pancreatitis. Multiple pancreatic biopsies at that time revealed no evidence of malignancy. The patient denied a past history of gallbladder disease, jaundice, and ethanol abuse. Physical examination demonstrated ascites. Significant laboratory determinations included alkaline phosphatase 33 U, GGTP 20 IUL, amylase 19 1UL, and total bilirubin 0.5 mg/dl (all within the normal range). The ascitic fluid amylase was normal. Ultrasound documented ascites and splenomegaly. Computed tomography of the abdomen revealed irregular Address reprint requests to :

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