Small bowel varices: report of two cases

Ishida, Hideaki; Konno, Kunihiko; Hamashima, Y.; Komatsuda, Tomoya; Naganuma, Hiroko; Asanuma, Yoshihiro; Ishida, Jun; Masamune, Osamu

doi:10.1007/s002619900360

Cited by 11 publications

(1 citation statement)

References 15 publications

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“…Various treatments have been carried out through the years: portal vein dilatation, portal stenting, bilioenteric reanastomosis, embolization, splenectomy, shunt operation, and endoscopic procedures. [11][12][13][14][17][18][19][20][21][22][23][24][25][26] Neumann et al 13 first reported the treatment using endoscopy. Their case was also a patient with pancreatic cancer whose portal vein was obstructed 1 year after operation.…”

Section: Discussionmentioning

confidence: 99%

Unusual Bleeding From Hepaticojejunostomy Controlled by Adult Variable Stiffness Colonoscopy: Report of a Case and Literature Review

Baba

Wakabayashi²,

Oba³

et al. 2014

International Surgery

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We herein present a case of a 59-year-old man who had undergone pylorus preserving pancreaticoduodenectomy with regional lymph node dissection prior to episodes of melena. Series of conventional endoscopic investigations failed to identify the bleeding source. Enhanced computed tomography scan revealed complete obstruction of the main portal vein with numerous collateral veins running towards the hepatic hilus. Comprehensively, hemorrhage from the jejunal varices caused by postoperative portal hypertension was highly suspected. As the jejunal loop was out of reach, adult variable-stiffness colonoscope (AVSC) was utilized to solve the Roux-en-Y anatomy. Numerous telangiectasis and small varices at hepaticojejunostomy were observed and in the mean time, bleeding was noticed and endoclips were placed without any delay. Ectopic variceal bleeding in jejunal loop after pancreaticoduodenectomy is difficult to manage. We believe that AVSC is an alternative device when specialized jejunal endoscopy is not available.

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Section: Discussionmentioning

confidence: 99%

Unusual Bleeding From Hepaticojejunostomy Controlled by Adult Variable Stiffness Colonoscopy: Report of a Case and Literature Review

Baba

Wakabayashi²,

Oba³

et al. 2014

International Surgery

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Controlling the bleeding of jejunal varices formed at the site of choledochojejunostomy: report of 2 cases and a review of the literature

et al. 2012

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Hemorrhage from jejunal varices formed at the site of Roux-en-Y choledochojejunostomy is rather rare, and no guidelines have so far been established for its treatment. This report presents the cases of 2 patients with jejunal varices formed at the site of choledochojejunostomy that were treated using different methods. An obstruction of the extrahepatic portal vein resulted in massive gastrointestinal bleeding in both cases CASE 1: A 59-year-old male developed jejunal varices at the site of choledochojejunostomy. Multidetector computed tomography showed that the source of bleeding was located in the small intestine near portojejunal varices. The jejunal vein supplying the afferent loop was embolized using interventional radiology. There was no evidence of liver dysfunction or rebleeding after the embolization CASE 2: A 79-year-old female developed jejunal varices at the site of choledochojejunostomy. Abdominal angiography could not detect the source of bleeding, and hence, a mesocaval shunt operation was performed.

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Novel Bile Duct Repair for Bleeding Biliary Anastomotic Varices: Case Report and Literature Review

Smith

Walsh

Henderson

2005

Journal of Gastrointestinal Surgery

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Small bowel varices: report of two cases

Cited by 11 publications

References 15 publications

Unusual Bleeding From Hepaticojejunostomy Controlled by Adult Variable Stiffness Colonoscopy: Report of a Case and Literature Review

Unusual Bleeding From Hepaticojejunostomy Controlled by Adult Variable Stiffness Colonoscopy: Report of a Case and Literature Review

Controlling the bleeding of jejunal varices formed at the site of choledochojejunostomy: report of 2 cases and a review of the literature

Novel Bile Duct Repair for Bleeding Biliary Anastomotic Varices: Case Report and Literature Review

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