Massive duodenal variceal bleed: endoscopic ultrasonography of ruptured varix and successful endoscopic clipping treatment

Lienhart, Isabelle; Lesne, Adriane; Couchonnal, Eduardo; Rivory, Jérôme; Sosa-Valencia, Leonardo; Ponchon, Thierry; Pioche, Mathieu

doi:10.1055/s-0042-102959

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…Duodenal varices can result in massive gastrointestinal bleeding, reported at around 40% mortality; diagnosis and treatment are often difficult and controversial as experience is limited [2 , 4] . The therapies have been reported to be efficacious for duodenal variceal bleed, including endoscopic variceal ligation (EVL), endoscopic injection sclerotherapy (EIS) and TIPS [5 , [10] , [11] , [12] .…”

Section: Discussionmentioning

confidence: 99%

Ectopic duodenal variceal bleed successfully treated with TIPS and 2 years follow-up: A Case Report

Liu

et al. 2020

Radiology Case Reports

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Duodenal varices are an uncommon presentation of portal hypertension and can result in significant gastrointestinal bleeding with a high mortality. Diagnosis can be difficult and therapeutic options limited. We present a case of upper gastrointestinal bleeding in a woman aged 54 years with primary biliary cholangitis who was ultimately diagnosed with ectopic duodenal variceal bleed, which was successfully treated with transjugular intrahepatic portosystemic shunt. Transjugular intrahepatic portosystemic shunt provide an effective treatment for ectopic duodenal variceal bleed caused by liver cirrhosis, though interventional radiologists need to remain aware of and vigilant for the complications and risks of this treatment option.

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Section: Discussionmentioning

confidence: 99%

Ectopic duodenal variceal bleed successfully treated with TIPS and 2 years follow-up: A Case Report

Liu

et al. 2020

Radiology Case Reports

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“…However, caution must be exercised when using the cyanoacrylate injection as it can lead to complication such as migration to lungs (causing pulmonary embolism) [ 19 ], abdomen and pelvis [ 20 ]. Endoscopic haemostasis using mini loop ligation with detachable nylon loop [ 21 ], and endoscopic ultrasonography (EUS)-guided clipping [ 22 ], embolization coiling [ 23 , 24 ] were attempted, with good outcomes even in acute emergency setting. If the bleeding is not controlled by endoscopic therapy, the patient can either undergo interventional radiological treatment or emergency surgery, depending on the availability of expertise and status of the patient.…”

Section: Discussionmentioning

confidence: 99%

A case report of bleeding from a duodenal varix: Rare cause of upper gastrointestinal bleeding

Khor

Soon

Aung

2018

International Journal of Surgery Case Reports

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HighlightsEctopic Varices (ECV) bleeding is uncommon but potentially life threatening cause of UGIB.Duodenum is the most common location of ECV.It should be considered in patient with severe UGIB but no bleeding source identifiable with endoscopy and conventional imaging studies.Endoscopic ligation or injection sclerotherapy is the first-line of treatment.Interventional radiology and surgery are appropriate options if endoscopic therapy fails.

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“…EUS plays an important role in determining the exact site, size, and location necessitating targeted therapy. Unfortunately, few case reports exist on using EUS-guided vascular therapy for DV[ 59 - 61 ] (Figure 4 ).…”

Section: Eus-guided Management Of Variceal Bleedmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Dhar¹,

Samanta²

2023

World J Gastrointest Endosc

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Endoscopic ultrasound (EUS) has expanded its arena from a mere diagnostic modality to an essential therapeutic tool in managing gastrointestinal (GI) diseases. The proximity of the GI tract to the vascular structures in the mediastinum and the abdomen has facilitated the growth of EUS in the field of vascular interventions. EUS provides important clinical and anatomical information related to the vessels' size, appearance and location. Its excellent spatial resolution, use of colour doppler with or without contrast enhancement and ability to provide images “real-time” helps in precision while intervening vascular structures. Additionally, structures such as venous collaterals or varices can be dealt with optimally using EUS. EUS-guided vascular therapy with coil and glue combination has revolutionized the management of portal hypertension. It also helps to avoid radiation exposure in addition to being minimally invasive. These advantages have led EUS to become an upcoming modality to complement traditional interventional radiology in the field of vascular interventions. EUS-guided portal vein (PV) access and therapy is a new kid on the block. EUS-guided portal pressure gradient measurement, injecting chemotherapy in PV and intrahepatic portosystemic shunt has expanded the horizons of endo-hepatology. Lastly, EUS has also forayed into cardiac interventions allowing pericardial fluid aspiration and tumour biopsy with experimental data on access to valvular apparatus. Herein, we provide a comprehensive review of the expanding paradigm of EUS-guided vascular interventions in GI bleeding, portal vein access and its related therapeutic interventions, cardiac access, and therapy. A synopsis of all the technical details involving each procedure and the available data has been tabulated, and the future trends in this area have been highlighted.

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Massive duodenal variceal bleed: endoscopic ultrasonography of ruptured varix and successful endoscopic clipping treatment

Cited by 4 publications

References 2 publications

Ectopic duodenal variceal bleed successfully treated with TIPS and 2 years follow-up: A Case Report

Ectopic duodenal variceal bleed successfully treated with TIPS and 2 years follow-up: A Case Report

A case report of bleeding from a duodenal varix: Rare cause of upper gastrointestinal bleeding

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

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