Steevens C, Abdalla M, Kothari TH, Kaul V, Kothari S. Massive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review. World J Gastrointest Pharmacol Ther 2015; 6(4): 248-252 [PMID: 26558159 DOI: 10.4292/wjgpt.v6.i4.248]
Corresponding Author of This Article
Truptesh H Kothari, MD, MS, Assistant Professor, Director, Developmental Endoscopy Lab at UR, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States. truptesh_kothari@urmc.rochester.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Nov 6, 2015; 6(4): 248-252 Published online Nov 6, 2015. doi: 10.4292/wjgpt.v6.i4.248
Massive duodenal variceal bleed; complication of extra hepatic portal hypertension: Endoscopic management and literature review
Christopher Steevens, Maisa Abdalla, Truptesh H Kothari, Vivek Kaul, Shivangi Kothari
Christopher Steevens, Maisa Abdalla, Vivek Kaul, Shivangi Kothari, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States
Truptesh H Kothari, Developmental Endoscopy Lab at UR, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, Rochester, NY 14642, United States
Author contributions: All the authors equally contributed to this work.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Truptesh H Kothari, MD, MS, Assistant Professor, Director, Developmental Endoscopy Lab at UR, Division of Gastroenterology and Hepatology, Center for Advanced Therapeutic Endoscopy, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States. truptesh_kothari@urmc.rochester.edu
Telephone: +1-585-2754711 Fax: +1-585-2761911
Received: March 28, 2015 Peer-review started: March 28, 2015 First decision: May 13, 2015 Revised: June 29, 2015 Accepted: August 30, 2015 Article in press: August 31, 2015 Published online: November 6, 2015 Processing time: 229 Days and 15.1 Hours
Core Tip
Core tip: Bleeding from duodenal varices is a gastrointestinal emergency and focused patient history may help the clinician to suspect this life threatening diagnosis. Clinician’s need to have a high degree of suspicion for bleeding varices even in the absence of known cirrhosis if certain clinical characteristics are present, such as history of crush injury. If duodenal varices are diagnosed on endoscopy, endoscopic injection sclerotherapy can be a highly successful definitive intervention. The authors suggest ethanolamine injection sclerotherapy, though multiple alternative sclerosants are also established in the literature as are other therapeutic alternatives including endoscopic band ligation. With prompt endoscopic management, life threatening bleeding can be effectively mitigated and with the expectation of excellent long term outcomes.
