Várices ectópicas en yeyuno proximal asociadas a sangrado recurrente en paciente sin cirrosis hepática
DOI:
https://doi.org/10.22516/25007440.442Palabras clave:
Hipertensión portal, várices yeyunales, sangrado intestinal bajo oculto u oscuroResumen
Las várices ectópicas (VE) en yeyuno son alteraciones vasculares infrecuentes, asociadas en mayor medida a la hipertensión portal (5%). Cuando se presenta sin esta asociación son aún menos frecuentes.
Presentamos un caso de sangrado crónico intestinal de varios años, sin hipertensión portal proveniente de várices localizadas en yeyuno proximal, su curso clínico, los elementos de diagnóstico empleados y terapia quirúrgica.
Descargas
Referencias bibliográficas
Raju G, Gerson L, Lewis B, American Gastroenterological Association (AGA) Institute Technical. Review on obscure gastrointestinal bleeding. Gastroenterology 2007; 133: 1697-1717.
Rondonotti E, Villa F, Mulder C, Maarten J, de Franchis R, Small Bowel capsule endoscopy in 2007 Indications, risk an limitations. World J Gastroenterol 2007; 13 (46):6140-6149.
Farrel J, Friedman L, Review article: The management of lower gastrointestinal bleeding. Aliment Pharmacol Ther 2005; 21: 1281-1298.
ASGE. The role of endoscopy in the management of obscure GI bleeding Gastrointestinal Endosc 2010; 72(3): 471-479.
Barnert J, Messman H. Diagnosis and management of lower gastrointestinal bleeding. Nat Rev Gastroenterol and Hepatol 2009; 6: 637-646.
Mitchell S, Schaefer C. A New View of Occult and obscure gastrointestinal bleeding. Am Fam Physician 2004; 69: 975-881.
Rockey D. Gastrointestinal Bleeding. En Sleisenger and Fordtrand’s. Gastrointestinal and liver disease. 8th edition. Saunders: Elsevier; 2006. p. 255-299.
Thomas O, Kovacs G, Jensen D. Lower gastrointestinal bleeding. En Hawkey C, Bosh J, Richter J, Garcia-Tasao G. Text book of Clinical Gastroenterology and Hepatology. Wiley Black Well; 2012. p. 132-138.
Lisa L, Lower GI. Bleeding: Epidemiology and Diagnosis. Gastroenterol Clin N Am 2005; 34: 643-664
Chalasani N, Clark W, Wilcox CM. Blood Urea Nitrogen to creatinine concentration in gastrointestinal bleeding: A reappraisal. Am J Gastroenterol 1997; 92: 1796.
May A, Nachbar L, Schneider M, Christian E. Prospective comparison of push enteroscopy and push- and –pull enteroscopy in patients with suspected small-Bowel bleeding. Am J Gastroenterol 2006; 101: 2016-2024.
Arakawa D, Ohmiya N, Nakamura M, Honda W, Shirai O, Itoh A, Hirooka Y, Niwa Y, Maeda O, Ando T. Outcome after enteroscopy for patients with obscure GI bleeding: diagnostic comparison between double–balloon endoscopy and videocapsule endoscopy. Gastrointest Endosc 2009; 69; 4: 866-74.
Monsanto P, Almeida N, Lerias C, Figueredo P, Gouveia H, Sofia C. Is there still a role for Intraoperative enteroscopy in patient with obscure gastrointestinal bleeding? Rev Esp Enferm Dig 2012; 104: 190-6.
Shiro O, Aoyama T, Imagawa H, Shishido T, Kasuaki C. Effectiveness of polaprezinc for low-dose aspirin-induced small-bowel mucosal injuries as evaluated by capsule endoscopy: a pilot randomized controlled study. Gastroenterology 2013; 13: 108.
Galiano M, Cepeda R, García F. Angiodisplasias de intestino delgado, presentación de dos casos. Rev Colomb Gastroenterol 2004; 19: 269-276.
Ahmed H, Khalid Al, Kahtani Al, Fadda M. Updates in the pathogenesis, diagnosis and management of ectopic varices. Hepatol Int 2008; 2: 322-334.
Brechman T, Wolf S, Volkmar N, Markus R. Gastrointestinal bleeding 30 years after complicated cholecitectomy. World J Gastroenterol 2010; 16(37): 4747-4750.
Saeki Y, Ide K, Kakisawa H, Ishikawa M, Tashiro H, Ohda H. Controlling the bleeding of jejunal varices formed at the site of choledochojejunostomy: report of two cases and a review of literature. Surg Today 2013; 43 (5): 550-5.
Watanabe N, Toyonaga A, Seichiro K, Takashimizu S, Kazuhiko O, Kokubo S, et al. Current status of ectopic varices in Japan: Results of a survey by the Japan Society for Portal Hypertension. Hepatol Res 2010; 40: 763-776.
De Palma G, Rega M, Masone S, Persico F, Siciliano S, Patrone F, Matantuono L, Persico G. Mucosal abnormalities of the small bowel in patients with cirrhosis and portal hypertension: a capsule endoscopy study. Gastrointest Endosc 2005; 4: 529-34.
Aoyama T, Oka S, Aikata H, Nakano M, Watari I, Neshiro N, et al. Small Bowel abnormalities in patients with compensated liver cirrhosis. Dig Dis Sci 2013; 58: 1390-1396.
Sandeep K, Dennis A. Occult massive Hemorrhage in a patient with cirrhosis. Ann Am Thorac Soc 2013; 10: 160-162.
Woong C, Kim S, Woong H, Yun L, Sung J, Sup H, Kim A, et al. A case of variceal bleeding from jejunum in liver cirrhosis. Clin and Mol Hepatol 2013; 19: 78-81.
Ohtani T, Kajiwara E, Suzuki N, Kawasaki A, Sadoshima S, Sakata H, Sasaguri Y, Onoyama K. Ileal varices associated with recurrent bleeding in a patient with liver Cirrhosis. J Gastrenterol 1999; 34(2): 264-8.
Yamada A, Watanabe H, Shuntaro O, Sugimoto T, Kondo S, Ohta M, Togo G. Surveillance of small intestinal abnormalities in patients with hepatocelular carcinoma: A prospective capsule endoscopy study. Digest Endosc 2011; 23: 124-129.
Kastanakis M, Anyfantakis D, Katsougris N, Bobulakis E, Masive gastrointestinal bleeding due to isolated jejunal varices in a patient without portal hypertension. Int J Surg 2013; 4(5): 439-441
Bhagwat S, Borwankar S, Ramadwar R, Naik A, Gajaree E. Isolated jejunal varices. J Posgrad Med 1995; 41: 43-4.
Joo Y, Kim S, Choi S, Rew J, Kim H. Massive gastrointestinal bleeding from jejunal varices. J Gastroenterol 2000; 35(10): 775-8.
Ambiru S, Nakamura S, Mandai Y, Sato T, Kuwahara T, Yokosuka O. Ectopic ileal varices associated with recurrent bleeding: report of case. Surg Today 2011; 41(3): 448-52.
Shiv S, Chandan K, Kumar N. Ectopic varices. Clin Liv Dis 2012; 5: 167-172.
Ostrow B, Balnchard R, Bledding small-bowel varices. Can J Surg 1984; 27(1): 88-9
Yuki N, Kubo M, Kasahara A, Hayashi N, Ito T, Kamada T. Jejunal varices as cause of massive gastrointestinal bleeding. Am J Gastroenterol 1992; 87(4): 514-7.
Naofumi E, Shigeaki A, Masao H, Takajashi M, Masatoshi T, Atsushi T. Jejunal varices as cause of massive Gastrointestinal bleeding a case report. Kur Med Journal 1998; 45 (2): 227-230.
Ueda J, Yoshida H, Mamada Y, Mizuguchi Y, Shimizu T, Matzumoto S, Ishikawa Y, Kakinuma D, et al. Successful emergency enterectomy for bleeding ileal varices in a patient with liver cirrhosis. J Niponn Med Sch 2006; 73(4): 221-5.
Koo S, Soung J, Jae J, Tae L, Seong R, Kim H, Kim J, Kim Y. Jejunal Variceal Bleeding Successfully treated with percutaneous coil embolization. J Korean Med Sci 2012; 27: 321-324.
Lee-Guam L, Yin-Mei L, Lenny T, Chang S, Sen-Gee L. Percutaneos paraumbilical embolization as an unconventional and successful treatment for bleeding jejunal varices. World J Gastroenterol 2009; 15(30): 3823-3826.
Ghindrim G, Mishim I, Zastavnitsky G. Ruptured duodenal varices successfully treated by mini–loop Ligation: report a case. Chirurgia 2010; 104: 625-629.
Nakata M, Nakata W, Isoda N, Yoshizawa M, Sugimoto H, Percutaneous retrograde sclerotherapy for refractory bleeding of jejunal varices: direct injection via superficial epigastric vein. Cadivasc Intervent Radiol 2012; 35: 203-6.
Koushi H, Kunihiro Y, Toshio D, Takahashi T, Sato M. Ruptured duodenal varices Successfully treated with Balloon-Occluded Retrograde Transvenous Obliteration: Usefulness of Microcatheters. ARJ 2003; 181: 725-727.
Kochar N, Tripathi D, Mcavoy C, Ireland D, Redhead N, Hayes P. Bleeding ectopic varices in cirrhosis: role of transjugular portosistemic stent shunts. Aliment Pharmacol Ther 2008; 28: 294-303.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
| Estadísticas de artículo | |
|---|---|
| Vistas de resúmenes | |
| Vistas de PDF | |
| Descargas de PDF | |
| Vistas de HTML | |
| Otras vistas | |
