Successful Emergency Enterectomy for Bleeding Ileal Varices in a Patient with Liver Cirrhosis

Ueda, Junji; Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Mizuguchi, Yoshiaki; Shimizu, Tetsuya; Matsumoto, Satoshi; Kakinuma, Daisuke; Ishikawa, Yoshinori; Kanda, Tomohiro; Akimaru, Koho; Teranishi, Nobuhisa; Naito, Zenya; Tajiri, Takashi

doi:10.1272/jnms.73.221

Cited by 20 publications

(18 citation statements)

References 7 publications

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“…Therapeutic interventions for PHE have been reported in 5–38.9% of patients with PHE, including endoscopic treatment using balloon endoscopy, radiological interventions and surgery, argon plasma coagulation and/or hemoclips, and polidocanol injection having been used to achieve hemostasis [22, 25, 31, 33-35]. Various modalities have also been used for the treatment of small-bowel varices [36-40]. Ultimately, treatment of PHE should be individually tailored to each patient’s clinical situation and should consider the available therapy, local expertise, and the indications.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Portal Hypertensive Enteropathy Exacerbation in Patients with Liver Cirrhosis: A Capsule Endoscopy Study

et al. 2018

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Background/Aims: The clinical course and exacerbation of portal hypertensive enteropathy (PHE) are yet to be fully clarified. This study aimed to identify factors related to PHE exacerbation in patients with liver cirrhosis (LC). Methods: Fifty patients with LC (33 male; mean age, 67 years), who underwent capsule endoscopy (CE) at the Hiroshima University Hospital between February 2009 and September 2015, were followed up for >6 months. Exacerbation is defined as the appearance of new lesions or worsening of existing lesions. The association between PHE exacerbation and the clinical factors was evaluated. Results: PHE exacerbation was identified in 24 out of 50 (48%) of cases: erythema (14 cases); angioectasia (11 cases); erosions (9 cases); villous edema (8 cases); and esophageal varices (EVs; 6 cases). The following factors were significantly associated with PHE exacerbation: portosystemic shunts, EVs and portal hypertensive gastropathy (PHG) exacerbation. After therapy, CE findings among the 24 cases were as follows: villous edema (19 cases); erythema (17 cases); angioectasia (16 cases); erosions (12 cases); and EVs (9 cases), and no observable abnormalities in 2 cases. On multivariate analysis, exacerbation of EVs and PHG were independent predictors of PHE exacerbation. Conclusion: EVs and PHG exacerbation may predict PHE exacerbation in patients with LC.

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Section: Discussionmentioning

confidence: 99%

Predictive Factors of Portal Hypertensive Enteropathy Exacerbation in Patients with Liver Cirrhosis: A Capsule Endoscopy Study

et al. 2018

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“…2 In a review of the literatures in PubMed from 1982 to 2007, a total of 14 cases was reported as ileal variceal bleeding. 1,4,5,7,[19][20][21][22][23][24][25][26][27][28] Among these 14 cases of ileal varix, 12…”

Section: Discussionmentioning

confidence: 99%

“…1,4,5,7,19,20,[22][23][24][25][26][27] All of theses cases, bar one had operations performed. 1,4,5,7,19,20,[22][23][24][25][26][27][28] 8 cases of them had a history of previous abdominal surgery. 1,4,19,22,23,[25][26][27] There were no cases that involved AVMs.…”

Section: Discussionmentioning

confidence: 99%

“…1 Bleeding from ileal varices is far less frequent and the reported cases seem to be associated with prior intra-abdominal surgery and adhesions. [2][3][4][5] However, considering that intestinal and colonic arteriovenous malformation (AVM) could cause dilated collateral veins and aggravate portal hypertension, 6,9 AVM in the ileocecal area can cause ileal varices and bleeding in patients with the portal hypertension without previous intra-abdominal surgery. We report a case of massive bleeding from the ileocecal varices associated with AVM in a patient with alcoholic liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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Arteriovenous Malformation Causing Ileocecal Variceal Bleeding in Liver Cirrhosis: Case Report and Review of the Literature

Park

Shin²,

Hong³

et al. 2008

Gut Liver

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Varices that occur at sites other than the esophagogastric area are termed ectopic varices. An ileal varix is a very rare cause of lower gastrointestinal bleeding. Although ileal varices are generally associated with prior intra-abdominal surgery and adhesions, an arteriovenous malformation (AVM) in the ileocecal area can cause ileal varices and bleeding in patients with portal hypertension who have not received previous intra-abdominal surgery, which is due to an intestinal or colonic AVM dilating the collateral veins and further aggravating portal hypertension. Surgical treatment should be considered in patients with massive ectopic variceal bleeding. We report a case of massive ileocecal variceal bleeding associated with an AVM that occurred in a patient with alcoholic liver cirrhosis. (Gut and Liver 2008;2:54-59)

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“…8 However, when a more diffuse bleeding pattern is the clinical scenario, a more pathophysiological surgical approach, i.e. portosystematic shunt procedure should be adopted.…”

Section: Introductionmentioning

confidence: 99%

Mesocaval shunt for portal hypertensive small bowel bleeding documented with intraoperative enteroscopy

Symeonidis

Koukoulis

Christodoulidis

et al. 2012

International Journal of Surgery Case Reports

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Successful Emergency Enterectomy for Bleeding Ileal Varices in a Patient with Liver Cirrhosis

Cited by 20 publications

References 7 publications

Predictive Factors of Portal Hypertensive Enteropathy Exacerbation in Patients with Liver Cirrhosis: A Capsule Endoscopy Study

Predictive Factors of Portal Hypertensive Enteropathy Exacerbation in Patients with Liver Cirrhosis: A Capsule Endoscopy Study

Arteriovenous Malformation Causing Ileocecal Variceal Bleeding in Liver Cirrhosis: Case Report and Review of the Literature

Mesocaval shunt for portal hypertensive small bowel bleeding documented with intraoperative enteroscopy

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