Intractable bleeding from anorectal varices relieved by inferior mesenteric vein ligation

Yeh, Thomas; McGuire, Hunter H.

doi:10.1016/0016-5085(94)90243-7

Cited by 22 publications

(8 citation statements)

References 5 publications

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“…Successful surgical ligation has also been reported [92,93]. Intractable bleeding is rare but has been treated with inferior mesenteric vein ligation and with TIPS [94,95]. Medical therapy has not been thoroughly evaluated.…”

Section: Colorectal Varicesmentioning

confidence: 99%

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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Section: Colorectal Varicesmentioning

confidence: 99%

Extraesophageal Varices

Kotfila¹,

Trudeau²

1998

Dig Dis

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“…There is no common consensus regarding the the- rapeutic management of bleeding anorectal varices (2). Control of a hemorrhage has been documented with endoscopic sclerosant injection (10), band ligation (11), inferior mesenteric vein ligation (12), and variceal embolization therapy (13). However, anorectal varices seem to re-bleed in most patients unless a definite reduction of the portal venous pressure is achieved.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with transjugular intrahepatic portosystemic shunt (TIPS) of recurrent massive rectal bleeding due to portal hypertension: Case report

Yesilkaya

Çil²,

Peynircioğlu³

et al. 2013

Turk J Gastroenterol

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“…Instant variceal decompression and cessation of bleeding was demonstrated in a case report by Yeh and McGuire [89], although this procedure is rarely performed.…”

Section: Suture Ligation and Stapled Anopexymentioning

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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Intractable bleeding from anorectal varices relieved by inferior mesenteric vein ligation

Cited by 22 publications

References 5 publications

Extraesophageal Varices

Extraesophageal Varices

Successful treatment with transjugular intrahepatic portosystemic shunt (TIPS) of recurrent massive rectal bleeding due to portal hypertension: Case report

The Management of Bleeding from Anorectal Varices

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