Wei ZJ, Zhu X, Yu HT, Liang ZJ, Gou X, Chen Y. Severe hematuria due to vesical varices in a patient with portal hypertension: A case report. World J Clin Cases 2021; 9(18): 4810-4816 [PMID: 34222452 DOI: 10.12998/wjcc.v9.i18.4810]
Corresponding Author of This Article
Yong Chen, MD, Associate Professor, Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China. tankchenyong@126.com
Research Domain of This Article
Urology & Nephrology
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/
Zong-Jie Wei, Xin Zhu, Hai-Tao Yu, Zong-Jian Liang, Xin Gou, Yong Chen, Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Wei ZJ and Zhu X collected the data, reviewed the literature, and contributed to manuscript drafting; Chen Y, Liang ZJ, and Yu HT were the patient’s surgeons and contributed to manuscript drafting; Chen Y and Gou X were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Yong Chen, MD, Associate Professor, Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China. tankchenyong@126.com
Received: January 25, 2021 Peer-review started: January 25, 2021 First decision: March 25, 2021 Revised: April 2, 2021 Accepted: April 23, 2021 Article in press: April 23, 2021 Published online: June 26, 2021
Abstract
BACKGROUND
Hematuria is one of the most common clinical symptoms for urologists and is typically observed in urinary system tumors, prostate hyperplasia, and urinary stone disease. Hematuria due to vesical varices is very rare, and only a few cases have been reported since 1989. We report the first case of vesical varices due to portal hypertension with aberrant development and functioning of the genitourinary system along with the complete diagnosis and treatment process.
CASE SUMMARY
This patient was a 53-year-old man with a history of aberrant development of the genitourinary system and hepatitis B-associated cirrhosis. He was admitted to the emergency department with severe hematuria and bladder clot tamponade. Many abnormally dilated blood vessels were found surrounding the bladder in the pelvis by color Doppler ultrasound, contrast-enhanced computed tomography, and three-dimensional visualization technology. It was difficult to perform transurethral cystoscopy and hemostasis in this patient, so we performed open surgical bladder exploration for hemostasis and surgical devascularization around the bladder.
CONCLUSION
Urologists should improve the understanding of the pathophysiology, clinical manifestations, diagnosis, and treatment of vesical varices. This case may be presented as a reference for the diagnosis and management of severe hematuria due to vesical varices.
Core Tip: Hematuria due to vesical varices is very rare. Here, we report a case of vesical varices due to portal hypertension with aberrant development and functioning of the genitourinary system, review the literature, and discuss its pathophysiology, clinical manifestations, diagnosis, and treatment.
