Bleeding from varices outside the gastroesophageal region is a rare, but regularly reported complication of portal hypertension. The treatment differs from the management of esophageal and gastric varices. We present here a report on the diagnosis and treatment of bleeding jejunal and gallbladder varices in a man with portal hypertension caused by chronic calcifying pancreatitis. The patient was suffering from recurrent, frequent, and massive gastrointestinal bleeding from varices at the anastomotic area of a cholecystojejunostomy. For diagnostic purposes, we carried out percutaneous Duplex ultrasonography and push enteroscopy with the Doppler technique.
The treatment of varices in this area is traditionally surgical. This is the first report of enteroscopic sclerotherapy being successfully carried out using cyanoacrylate to treat hemorrhage from jejunal and gallbladder varices. No clinical signs of gastrointestinal bleeding were observed during a follow-up period of seven months.
References
1
Wilson S E, Stone R T, Christie J P, Passaro E.
Massive lower gastrointestinal bleeding from intestinal varices.
Arch Surg.
1979;
114
1158-1161
2
Paquet K J, Lazar A, Bickart J.
Massive and recurrent gastrointestinal hemorrhage due to jejunal varices in an afferent loop: diagnosis and management.
Hepatogastroenterology.
1994;
41
276-277
5
Chawla A, Dewan R, Sarin S K.
The frequency and influence of gallbladder varices on gallbladder functions in patients with portal hypertension.
Am J Gastroenterol.
1995;
90
2010-2014
6
Rathi P M, Soni A, Upadhyay A P, et al.
Gallbladder varices: diagnosis in children with portal hypertension on duplex sonography.
J Clin Gastroenterol.
1996;
23
228-231
