Rupture of jejunal varices treated with balloon-occluded retrograde transvenous obliteration

Osame, Akinobu; Higashihara, Hideyuki; Urakawa, Hiroshi; Kora, Shinichi; Yoshimitsu, Kengo

doi:10.1007/s11604-012-0139-7

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Our initial search yielded 395 case reports of SIV in patients with cirrhosis, of which 76 (19.2%) reported SIV bleeding and were included for collation and analysis (9–20,21–30,31–40,41–50,51–60,61–78). Mean age was 52.4 years (range 40–68), 32 were women, and 44 were men.…”

Section: Resultsmentioning

confidence: 99%

Small Intestine Varices in Cirrhosis at a High-Volume Liver Transplant Center: A Retrospective Database Study and Literature Review

et al. 2021

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INTRODUCTION: Esophageal varices are a well-characterized sequela of portal hypertension; however, less is known about varices arising in ectopic locations. We aimed to describe bleeding small intestine varices (SIV) in patients with cirrhosis and compare characteristics and outcomes to published case reports. METHODS: We performed an institutional chart review using billing codes and natural language processing between 2008 and 2019. Inclusion criteria were adult patients with cirrhosis and SIV verified by endoscopy, video capsule, or imaging. Patients with noncirrhotic portal hypertension and stomal varices were excluded. We examined demographic and clinical factors, characteristics of SIV, bleeding, intervention, and outcomes in our series and collated data from published cases identified during a literature review. RESULTS: We identified 71 patients with cirrhosis and SIV (18 bled). The literature search yielded 76 cases with bleeding SIV. Our series and published cases were matched for age, sex, liver disease etiology, and SIV location. Length of stay and transfusion requirements were similar. Aggregate initial treatments (number, hemostasis rate) included medical (n = 7, 57%), endoscopic (n = 48, 56%), interventional radiology (n = 31, 77%), and surgery (n = 8, 87%). Hospital and overall mortality rates were higher in our series (22% and 38%) compared with the published cases (5.3% and 18.4%), respectively (P = 0.02 and P = 0.07). DISCUSSION: A quarter of patients with cirrhosis and SIV experience bleeding, with high transfusion requirements, frequent need for secondary interventions, and high mortality. These findings highlight the need for a multidisciplinary approach and second-line therapeutic modalities in the timely management of bleeding SIV in cirrhosis.

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Section: Resultsmentioning

confidence: 99%

Small Intestine Varices in Cirrhosis at a High-Volume Liver Transplant Center: A Retrospective Database Study and Literature Review

et al. 2021

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“…Although there are few case reports regarding hemostasis for ectopic varices, EBL is applied, and endoscopic sclerotherapy is performed especially when there is no active bleeding. 7,8 In some reports, endoscopic hemostasis was unsuccessful, but TIPS was effective for hemostasis. 3,5,9 Elective surgical treatment has also been reported previously.…”

Section: Discussionmentioning

confidence: 99%

Hemostasis With Endoscopic Band Ligation for Rupture of Jejunal Varices

et al. 2019

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Compared with the variceal rupture in the esophagus or stomach, rupture of ectopic varices including those in the jejunum is rare, and a definitive hemostatic method is not established. We report our case and review the literature regarding the pathophysiology and hemostatic methods of ectopic varices. A patient presented with hematemesis and cardiopulmonary arrest following hemorrhagic shock. After resuscitation, we performed emergency endoscopy and diagnosed ruptured jejunal varices that were subsequently treated by endoscopic band ligation.

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Rupture of jejunal varices treated with balloon-occluded retrograde transvenous obliteration

Cited by 2 publications

References 8 publications

Small Intestine Varices in Cirrhosis at a High-Volume Liver Transplant Center: A Retrospective Database Study and Literature Review

Small Intestine Varices in Cirrhosis at a High-Volume Liver Transplant Center: A Retrospective Database Study and Literature Review

Hemostasis With Endoscopic Band Ligation for Rupture of Jejunal Varices

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