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

Abstract

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.

Massive gastrointestinal bleeding due to ectopic varix in distal duodenum: a case report

“…Our case presented with DEV in the distal duodenum and had no evidence of esophageal or gastric varices on endoscopy. Previous cases have reported DEV in the distal duodenum [15][16][17], but they are extremely uncommon. Push enteroscopy has been used in previous case reports to detect ectopic varices [18].…”

Endoscopic Band Ligation of Bleeding Duodenal Varices

“…Khor et alreported a rare case of recurrent upper gastrointestinal bleeding requiring multiple EGDs and eventually found to have bleeding duodenal varices in the second and third portion of the duodenum. The patient was taken urgently to the operating room for duodenectomy with good recovery [1].…”

“…Although the stomach and esophagus are the most common sites of varices, they can infrequently be found in ectopic locations such asthe rectum, appendix, small intestine, colon, and biliary tract [1]. Ectopic variceal bleeding is an uncommon phenomenon, occurring in approximately 2%-5% of variceal bleeding [1].Duodenal varices account foronly17% of total ectopic variceal bleeding and havean estimated mortality rate of 40%, attributed to increased vascularity of the duodenum and the deep serosal location of duodenal varices [1][2][3]. Management of bleeding ectopic varices usually requires an endoscopic treatment or radiologic intervention and rarely surgical intervention.…”