Duodenal varices diagnosed by endoscopic ultrasound: A case report

Portal hypertension and associated complications cause significant morbidity and mortality in cirrhotic patients. Variceal development is the most important portal hypertension related complication. Varices most commonly occur around the gastroesophageal junction, but ectopic varices may develop in many gastrointestinal and extra-gastrointestinal localizations. Duodenum is one of the most common localizations for ectopic varices. Diagnosis of duodenal varices is usually made by upper gastrointestinal endoscopy, but endoscopic appearance is not diagnostic and usually further investigations are required in order to make accurate diagnosis. Endoscopic ultrasound is the gold standard method for the examination of gastrointestinal submucosal lesions therefore it is also useful in the work up of suspected duodenal varices. Here we present a patient with cryptogenic liver cirrhosis followed in our clinic, whom duodenal lesions suspected of duodenal varices were noticed during upper gastrointestinal endoscopic examination and endoscopic ultrasound was used to confirm the presence of duodenal varices.

[1]  L. M. Wong Kee Song,et al.  Endoscopic ultrasound (EUS)-guided coil injection therapy of esophagogastric and ectopic varices , 2016, Surgical Endoscopy.

[2]  S. Sarin,et al.  Spectrum of hepatofugal collateral pathways in portal hypertension: an illustrated radiological review , 2015, Insights into Imaging.

[3]  S. Çifçi,et al.  External Hemorrhage from a Portacaval Anastomosis in a Patient with Liver Cirrhosis , 2014, Case reports in hepatology.

[4]  H. Aslanian,et al.  Bleeding From a Duodenal Varix: A Unique Case of Variceal Hemostasis Achieved Using EUS-guided Placement of an Embolization Coil and Cyanoacrylate , 2014, Journal of clinical gastroenterology.

[5]  S. Rana,et al.  Clinical, endoscopic and endoscopic ultrasound features of duodenal varices: A report of 10 cases , 2014, Endoscopic ultrasound.

[6]  H. J. Lee,et al.  Successful Treatment of Duodenal Variceal Bleeding by Endoscopic Clipping , 2013, Clinical endoscopy.

[7]  Viet N. Nguyen,et al.  Endoscopic duodenal variceal ligation: a series of 4 cases and review of the literature (with video). , 2012, Gastrointestinal endoscopy.

[8]  Y. Karino,et al.  Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension , 2011, International journal of hepatology.

[9]  T. Tajiri,et al.  Current status of ectopic varices in Japan: Results of a survey by the Japan Society for Portal Hypertension , 2010, Hepatology research : the official journal of the Japan Society of Hepatology.

[10]  Jing Yang,et al.  Clinical characteristics and endoscopic treatment with cyanoacrylate injection in patients with duodenal varices , 2009, Scandinavian journal of gastroenterology.

[11]  Khalid Al Kahtani,et al.  Updates in the pathogenesis, diagnosis and management of ectopic varices , 2008, Hepatology international.

[12]  T. Fukuda,et al.  Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis , 2005, European Radiology.

[13]  P. Kamath,et al.  Management of ectopic varices , 1998, Hepatology.

[14]  F. Khouqeer,et al.  Duodenal varices as a cause of massive upper gastrointestinal bleeding. , 1987, Surgery.

[15]  G. Stephan,et al.  [X-ray diagnosis of varicose duodenal changes in poratal hypertension]. , 1968, Der Radiologe.