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Related Experiment Videos

Bleeding from intestinal varices after a Warren shunt.

E Attias1, C Smadja, C Vons

  • 1Service de Chirurgie Hépato-Biliaire et Digestive, Faculté de Médecine Paris-Sud, Hôpital Paul Brousse, Villejuif, France.

Journal of Clinical Gastroenterology
|October 1, 1987
PubMed
Summary

Ruptured jejunal varices caused massive gastrointestinal bleeding in a patient 4 years after a Warren operation. This case highlights a potential cause of rebleeding following this surgical procedure.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Vascular Surgery

Background:

  • Alcoholic cirrhosis can lead to portal hypertension and gastrointestinal bleeding.
  • The Warren operation is a surgical procedure to manage complications of portal hypertension.
  • Rebleeding after surgical shunts can occur due to various factors.

Observation:

  • A 62-year-old man with alcoholic cirrhosis experienced massive gastrointestinal bleeding four years post-Warren operation.
  • Angiography indicated ruptured jejunal varices as the bleeding source.
  • Propranolol and a side-to-side portacaval shunt were ineffective in controlling the bleeding.

Findings:

  • Emergency laparotomy revealed hypervascular adhesions and a ruptured submucosal varix in the jejunum.
  • Intestinal varices post-Warren operation may develop due to persistent mesenteric hypertension.

Related Experiment Videos

  • Adhesions between the jejunum and retroperitoneum may contribute to varix formation.

    • Implications:

    • This case underscores a rare but serious complication of the Warren operation.
    • Understanding the pathophysiology of intestinal varices is crucial for managing post-shunt bleeding.
    • Further research into preventing and treating jejunal varices after surgical shunts is warranted.