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A rare cause of obscure upper gastrointestinal bleeding: A challenging experience
摘要
Introduction: Liver cirrhosis leads to a serious complication mainly the development of portal hypertension which causes catastrophic consequences namely variceal bleeding, encephalopathy, and hepatocellular carcinoma. Bleeding is commonly caused by ruptured esophageal, gastric, and rarely ectopic varices. We report here a patient with liver cirrhosis who presented with obscure upper gastrointestinal bleeding proved to be due to an ectopic varix. Case Report: Our patient is a 55-year-old known hepatitis C virus related cirrhotic man who presented with recurrent melena and hematochezia without abdominal pain. Physical examination was remarkable for pallor, jaundice, and ascites. Following resuscitation, upper endoscopy showed non-bleeding esophageal varices and colonoscopy was unremarkable. Further workup with CT angiography revealed the presence of sub mucosal varix at the level of a small bowel jejunal loop. This was successfully embolized by coiling under ultrasound guidance by the interventional radiologist. Conclusion: This report refreshes the minds about the proper diagnosis and management of obscure upper gastrointestinal bleeding caused by ectopic varices and emphasizes the important role of the interventional radiologist in this matter.
延伸閱讀
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