Portal Hypertension with Bleeding Vaginal Varices

Kreek, Mary Jeanne; Raziano, Joseph V.; Hardy, Robert E.; Jeffries, Graham H.

doi:10.7326/0003-4819-66-4-756

Cited by 26 publications

(8 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several of the reported cases of vaginal varicosities are associated with underlying venous congestion due to portal hypertension [ 2 , 10 , 17 ]. However, vaginal varicosities have rarely been reported, with only 10 reported cases between 1967 and 2016 which could be found in general reviews of the literature [ 1 , 2 , 6 , 10 , 13 , 17 , 18 ]. Vaginal varicosities are believed to be rare due to the number of outlets for venous flow via venous plexuses [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most likely and significant potential complications from our patient's vaginal varicosities include hemorrhage and thromboses during delivery. Several case reports have discussed bleeding from vaginal varicosities with etiologies rooted in portal hypertension [ 10 , 18 ]. Kikuchi et al documented a case of massive vaginal bleeding in a patient with vaginal varicosities after delivery of a 2562 g male infant with resultant hypotension of 64/35 mmHg treated with vaginal packing and blood transfusion [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Large Vaginal Varicosities in the Setting of Pregnancy without Known Hepatic or Vascular Risks: A Case Report and Review of the Literature

Sueyoshi

Clevenger

Hart

2018

Case Reports in Obstetrics and Gynecology

View full text Add to dashboard Cite

Pregnancy may cause the onset of vaginal or vulvar varicosities that may be a concern for hemorrhage risk during childbirth. A 38-year-old female G4P1112 at 34 weeks and 1 day was referred to an outpatient OB/Gyn clinic for evaluation of a large vaginal mass. The referring provider had concern for malignancy. Lesions of the vulva were biopsied and found to be benign. For two months prior to presentation, she was experiencing discomfort with walking, yellow vaginal discharge, and dysuria. Treatment with fluconazole showed no improvement. She denied any personal or family history of malignancies, varicosities, or hepatic issues. Past surgical history was significant for laparoscopic cholecystectomy and two cesarean sections. A large vaginal mass during pregnancy is a concern whether it is malignancy or large vaginal varicosities that may put the patient at risk of severe hemorrhage during childbirth. We concluded that the mass was large vaginal varicosities as there was no discernible etiology. A repeat cesarean section was recommended due to the risk of hemorrhage during childbirth. For long-term management, close observation postpartum was recommended. Spontaneous resolution is a potential outcome and this is what our patient experienced. Without an underlying etiology, supportive measures are the best options.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Large Vaginal Varicosities in the Setting of Pregnancy without Known Hepatic or Vascular Risks: A Case Report and Review of the Literature

Sueyoshi

Clevenger

Hart

2018

Case Reports in Obstetrics and Gynecology

View full text Add to dashboard Cite

show abstract

“…Bleeding from varices located in these places result in colonic, duodenal, small intestinal and even vaginal bleeding [5][6][7][8][9]. Rupture of extraintestinal varices, around ascending and descending colon, duodenum and pancreatic region, posterior aspect of the liver, and posterior to the spleenis a rare, lifethreatening complication associated with high mortality rates [10].…”

Section: Re[erences Discussionmentioning

confidence: 99%

Haemoperitoneurn Secondary to Rupture of Retroperitoneal Variceal

et al. 1997

View full text Add to dashboard Cite

A 45-year-old alcoholic male patient presented with hypovolemic shock and intense anemia (Hemoglobin 04.7 g/dl), and was operated on. A bleeding retroperitoneal varix located near the right colon was responsible for the clinical picture and was sutured. After operation the patient developed haemodynamic instability and pneumonia a situation which was reverted with intensive medical therapy. The patient is now doing well.

show abstract

“…Other more unusual sources of variceal bleeding have included vaginal-vault varices (Kreek et al, 1967), mesenteric varices (Rothschild, Gelernt and Sloan, 1968), colonic varices (Leevy et al, 1957) and varices occurring in inflammatory adhesions (Bloor and Orr, 1961). However, umbilical haemorrhage secondary to cirrhosis does not appear to have been previously reported.…”

Section: Introductionmentioning

confidence: 98%

Umbilical haemorrhage—an unusual complication of cirrhosis

Douglas¹

1981

Postgraduate Medical Journal

View full text Add to dashboard Cite

Summary A 59-year-old woman known to have micronodular cirrhosis presented with haemorrhage from the umbilicus. She eventually required exomphalectomy at which a huge patent umbilical vein was found and ligated. Selective coeliac and superior mesenteric angiography with late phase films confirmed a large umbilical vein filling from the left branch of the portal vein. So far as the author knows, umbilical haemorrhage as a complication of cirrhosis has never previously been reported.

show abstract

Portal Hypertension with Bleeding Vaginal Varices

Cited by 26 publications

References 3 publications

Large Vaginal Varicosities in the Setting of Pregnancy without Known Hepatic or Vascular Risks: A Case Report and Review of the Literature

Large Vaginal Varicosities in the Setting of Pregnancy without Known Hepatic or Vascular Risks: A Case Report and Review of the Literature

Haemoperitoneurn Secondary to Rupture of Retroperitoneal Variceal

Umbilical haemorrhage—an unusual complication of cirrhosis

Contact Info

Product

Resources

About