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Ruptured duodenal varices: the role of banding ligation

Mauricio Silva, Angelo Mattos, Joao Wilney, Alvaro Cassal, Juliana Bortoluzzi, Paulo Fontes

Am J Case Rep 2008; 9:43-46

ID: 744369

Background: The rupture of esophageal varices with gastrointestinal bleeding is the main cause of death in cirrhotic patients. In less than 5% of the situations, the bleeding is caused by ectopic varices. The appropriate treatment for the rupture of esophageal varices has been demonstrated by important and randomised studies. However, in case of ectopic variceal bleeding, the role of different strategies has been suggested by less relevant studies without “gold standard” proposal.
Case report: The authors present the case of a cirrhotic patient who was referred to hospital with upper gastrointestinal bleeding. During the endoscopic examination, active bleeding from duodenal varices was observed. At this time, variceal banding ligation was carried out and the bleeding was controlled. Later on, the patient was submitted to three more sessions of this procedure without re-bleeding.
Conclusion: This study present a case with duodenal variceal bleeding treated by endoscopic variceal ligation with satisfactory results, generating an opportune discussion about this unusual situation.

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