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01.12.2008 | Case report | Ausgabe 1/2008 Open Access

World Journal of Emergency Surgery 1/2008

Severe bleeding from esophageal varices resistant to endoscopic treatment in a non cirrhotic patient with portal hypertension

Zeitschrift:
World Journal of Emergency Surgery > Ausgabe 1/2008
Autoren:
Roberto Caronna, Mario Bezzi, Monica Schiratti, Maurizio Cardi, Giampaolo Prezioso, Michele Benedetti, Federica Papini, Simona Mangioni, Gabriele Martino, Piero Chirletti
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1749-7922-3-24) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

RC conceived of the study, wrote the manuscript and partecipated to surgical procedures and to preoperative and postoperative patient management, MB performed all radiological procedures, MS partecipated in manuscript design and coordination, MC partecipated to surgical procedures and to preoperative and postoperative patient management, GP partecipated to surgical procedures, MB partecipated in manuscript design and coordination, FP partecipated in manuscript design and coordination, SM participated in licterature reviewing and patient follow-up, GM participated in licterature reviewing and patient follw-up, PC was the first operator, is the Chief of the Surgical Unit and participated in manuscript design. All Authors read and approved the final manuscript.

Abstract

A non cirrhotic patient with esophageal varices and portal vein thrombosis had recurrent variceal bleeding unsuccessfully controlled by endoscopy and esophageal transection. Emergency transhepatic portography confirmed the thrombosed right branch of the portal vein, while the left branch appeared angulated, shifted and stenotic. A stent was successfully implanted into the left branch and the collateral vessels along the epatoduodenal ligament disappeared. In patients with esophageal variceal hemorrhage and portal thrombosis if endoscopy fails, emergency esophageal transection or nonselective portocaval shunting are indicated. The rare patients with only partial portal thrombosis can be treated directly with stenting through an angioradiologic approach.
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