Control of massive hemorrhage from rectal varices with sclerotherapy

Weiserbs, D.B.; Zfass, Alvin M.; Messmer, James M.

doi:10.1016/s0016-5107(86)71928-7

Cited by 35 publications

(17 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 1,2 Although several cases of significant hemorrhage from rupture of ectopic varices have been reported, reports on the treatment of bleeding rectal varices have been limited. 3–6 Some patients with massive hemorrhage from rectal varices have been treated with endoscopic injection sclerotherapy (EIS). 3,4 Only a few reports have described the treatment of massive hemorrhage from rectal varices with endoscopic variceal ligation (EVL) alone.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Variceal Ligation of Bleeding Rectal Varices: A Case Report

Shudo

Yazaki

Sakurai

et al. 2000

Digestive Endoscopy

View full text Add to dashboard Cite

The incidence of ectopic varices in the rectum is likely to increase with improvements in the treatment and survival of patients with portal hypertension. If a patient with portal hypertension suffers massive lower gastrointestinal hemorrhage, it is important to perform a detailed endoscopic examination, as there is a possibility of rectal varices. Although a standard therapy for rectal varices has not been established, we encountered a case of rectal varices that was successfully treated with endoscopic variceal ligation alone. Endoscopic variceal ligation is minimally invasive, safe, effective, simple and reliable. Endoscopic variceal ligation is promising as a possible first line of therapy for rectal varices.

show abstract

Section: Introductionmentioning

confidence: 99%

Endoscopic Variceal Ligation of Bleeding Rectal Varices: A Case Report

Shudo

Yazaki

Sakurai

et al. 2000

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…EIS was performed weekly, a mean of 2.7 times, with a mean total sclerosant volume of 5.2 mL injected per procedure. Whilst complications of erosions and ulceration have been associated with EIS of anorectal varices [44,45], none were observed in this series. These patients were compared to nine patients with anorectal varices treated with EBL.…”

Section: Endoscopic Injection Sclerotherapy (Eis)mentioning

confidence: 65%

“…The use of EIS to successfully treat bleeding anorectal varices was first described by Wang et al in 1985 [44], and other case reports of successful EIS for treatment of bleeding anorectal varices have subsequently been published [45][46][47]. Whilst EIS is considered a first-line treatment for bleeding anorectal varices, there is no current recommendation in relation to the concentration and volume of sclerosant to be injected.…”

Section: Endoscopic Injection Sclerotherapy (Eis)mentioning

confidence: 99%

The Management of Bleeding from Anorectal Varices

Robertson

Thompson

Hayes

2017

Curr Hepatology Rep

View full text Add to dashboard Cite

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.

show abstract

“…A rapid and accurate diagnosis is therefore required for patients with hemorrhaging anorectal varices; however, no therapeutic strategy has yet been established. Surgical and endoscopic ligation [7,8], endoscopic injection sclerotherapy (EIS) [9] and percutaneous transhepatic obliteration (PTO) [10] have been reported to be useful as therapeutic strategies for bleeding rectal varices. The transjugular intrahepatic portosystemic (TIPS) shunt has also been shown to attenuate the size of anorectal varices [11].…”

Section: Introductionmentioning

confidence: 99%

A case of liver cirrhosis due to hepatits C virus infection complicating giant anorectal varices treated with balloon-occluded retrograde transvenous obliteration

Watanabe

Imai

Takaya

et al. 2010

Clin J Gastroenterol

View full text Add to dashboard Cite

A 73-year-old man with liver cirrhosis due to hepatitis C virus infection was admitted to our hospital because of massive bleeding from external varices. Colonoscopic examination revealed that giant anorectal varices had developed between the anus and rectal ampulla, and had ruptured at the perianal site. On three-dimensional computed tomography imaging, the feeding and drainage vessels of the varices were identified as the inferior mesenteric vein and right inferior hemorrhoidal vein, respectively. Endoscopic therapies were not employed for the bleeding varices, because the blood flow volume of the feeding vessel was extremely large. Balloon-occluded retrograde transvenous obliteration (B-RTO) was therefore carried out through the drainage vessels. The variceal blood flow disappeared after B-RTO therapy, and the varices decreased in size with thrombus formation verified by colonoscopy. Bleeding from the external varices also ceased. B-RTO therapy may be an effective approach for giant anorectal varices presenting as a complication in liver cirrhosis patients in whom the main drainage vessels can be determined.

show abstract

Control of massive hemorrhage from rectal varices with sclerotherapy

Cited by 35 publications

References 12 publications

Endoscopic Variceal Ligation of Bleeding Rectal Varices: A Case Report

Endoscopic Variceal Ligation of Bleeding Rectal Varices: A Case Report

The Management of Bleeding from Anorectal Varices

A case of liver cirrhosis due to hepatits C virus infection complicating giant anorectal varices treated with balloon-occluded retrograde transvenous obliteration

Contact Info

Product

Resources

About