Massive gastrointestinal bleeding due to isolated jejunal varices in a patient without portal hypertension

Abstract

Diagnosis and management of isolated jejunal varices is challenging. Surgeons as well as acute care physicians have to consider idiopatic form of jejunal varices as a potential cause of gastrointestinal bleeding when gastroduodenoscopy and colonoscopy are negative.

Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma

“…Other options include endoscopic band ligation and injection sclerotherapy [10]. Surgical resection of the affected bowel segment has also been reported as a treatment option in previous cases with low recurrence rates [16], but it carries its own risks especially in patients with cirrhosis (Table 1, summary of main therapeutic options in the management of ectopic varices [15]).…”

Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature

“…The differential diagnosis is broad including hemangioma, splenic infarction, pseudocyst, epidermoid cyst, mesothelial cyst, parasitic or hydatid cysts, septic embolism, old hematomas, lymphoma or metastasis [ 9 , 10 ]. Preoperative diagnosis is difficult like as for other pathologies [ 11 ], depending on the non specificity of symptoms and signs; however it’s improved by medical imaging including abdominal ultrasound (US), abdominal CT scan and magnetic resonance imaging (MRI) [ 12 ]. The variability of lymphatic vessel caliber associated with some degree of fibrosis and calcification, provides a wide range of imaging aspects.…”

Endoscopic Sclerotherapy with a Large Volume of High Concentration of Cyanoacrylate for Jejunal Variceal Bleeding bys Single-Balloon Enteroscopy

“…The predisposing risk factors for jejunal varices formation are hepatic cirrhosis with portal hypertension, HCC, pancreatitis, a history of abdominal surgery, nodular lymphoid hyperplasia, and familial small intestinal varices without portal hypertension [ 8 ]. Previous abdominal surgery can lead to the development of ectopic varices at the surgical site or cause postsurgical jejunal adhesion.…”

“…Because of the anatomic location of jejunal varices compared with esophageal or gastric varices, jejunal varices bleeding is much more difficult to detect and manage [ 4 ]. Hence, successfully treatment has been rarely reported [ 5 , 6 , 7 , 8 ]. Although surgery is the first choice for managing active bleeding traditionally, it is invasive and risky, especially in patients with cirrhosis and poor hepatic function [ 7 , 8 ].…”

“…Hence, successfully treatment has been rarely reported [ 5 , 6 , 7 , 8 ]. Although surgery is the first choice for managing active bleeding traditionally, it is invasive and risky, especially in patients with cirrhosis and poor hepatic function [ 7 , 8 ]. Single-balloon enteroscopy (SBE) is designed to identify small intestinal lesions, and it has been reported as an efficient diagnostic and therapeutic tool for treating of bleeding due to small intestinal vascular lesions [ 9 ].…”