Elsevier

Radiology Case Reports

Volume 16, Issue 6, June 2021, Pages 1580-1585
Radiology Case Reports

Case Report
Bleeding duodenal varices urgently treated with TIPS and coil embolization in a patient with cirrhosis: A rare case

https://doi.org/10.1016/j.radcr.2021.03.046Get rights and content
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Abstract

Duodenal varices are ectopic varices that can cause severe and life-threatening gastrointestinal bleeding. Diagnosis and treatment of ectopic varices is challenging, because endoscopy is often unproductive in detecting and treating ectopic varices. Interventional radiology appears as an alternative in this setting, thanks to its important role in treating the bleeding caused by ectopic varices and in preventing rebleedings. We present an interesting case of bleeding ectopic varices in a male 62-years-old cirrhotic patient (Child-Pugh B8). The patient presented with hemorrhagic shock caused by massive melena. CT angiography showed intraluminal blood and identified the source of bleeding as an ectopic varicose vein draining into the superior mesenteric vein. Interventional radiology approach was the only applicable one to reach and effectively treat the source and cause of bleeding by TIPS placement and embolization of the collateral feeding at the same session

Keywords

Interventional radiology
Ectopic varices
Gastrointestinal bleeding
Endovascular treatment
TIPS
Coil embolization

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