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Related Experiment Videos

Bleeding varices located in the second portion of the duodenum.

M Sukigara, I Koyama, T Komazaki

    The Japanese Journal of Surgery
    |March 1, 1987
    PubMed
    Summary

    This study details a case of severe gastrointestinal bleeding in a patient with liver cirrhosis. Duodenal varices were identified as the bleeding source, and Doppler echography confirmed successful treatment via ligation and sclerotherapy.

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    Area of Science:

    • Gastroenterology
    • Hepatology
    • Vascular Surgery

    Background:

    • Liver cirrhosis can lead to serious complications like gastrointestinal bleeding.
    • Portal hypertension in cirrhosis often causes varices, which are enlarged veins.
    • Duodenal varices are a less common but potentially severe cause of upper GI bleeding.

    Observation:

    • A 41-year-old woman with cirrhosis presented with severe melena.
    • Blood pool scanning localized bleeding to the right upper abdomen.
    • Endoscopy revealed duodenal varices with erosion as the bleeding source, distinct from co-existing esophageal varices.

    Findings:

    • Ligation and sclerotherapy were performed due to persistent hypotension.
    • Intraoperative 2D Doppler echography visualized blood flow in duodenal varices.

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  • Post-procedure, Doppler signals indicating blood flow velocity disappeared, confirming treatment efficacy.

    • Implications:

    • Duodenal varices can be a significant source of bleeding in cirrhotic patients.
    • Doppler echography is effective for intraoperative assessment of variceal ligation and sclerotherapy.
    • Despite successful intervention, the patient succumbed to multiple organ failure, highlighting the severity of advanced cirrhosis.