Summary:
We report a case of haematemesis & melaena due to ectopic
varices located in the duodenum in a patient with NASH
related CLD. Duodenal varices are a rare but potentially
serious consequence of portal hypertension in the event of
a bleeding. The etiology of duodenal varices can be
classified into hepatic (e.g. cirrhosis) or extra hepatic (e.g.
portal, splenic or superior mesenteric vein thrombosis).
Endoscopic injection sclerotherapy (EIS) and endoscopic
variceal ligation (EVL) are widely accepted as primary
therapies for esophageal variceal bleeding whereas
bleeding gastric fundal varices are usually treated with
cyanoacrylate injection or shunt procedures. However there
is no widely accepted treatment modality for duodenal
varices. In the case presented, we used injection
sclerotherapy with ethanolamine oleate, to obliterate varices
and control bleeding. A short review on the etiology
pathogenesis and management of ectopic varices is
presented.
Key words: ectopic varices, cirrhosis, gastrointestinal
bleeding, portal hypertension, injection sclerotherapy
(J Bangladesh Coll Phys Surg 2019; 37: 156-159)
DOI: https://doi.org/10.3329/jbcps.v37i3.41738