J Clin Pract Res. Ahead of Print: CPR-54154 | DOI: 10.14744/cpr.2023.54154

The Nightmare of the Gastroenterologist: Bleeding Duodenal Varices

Idris Kurt
Department of Gastroenterology, Kastamonu Training and Research Hospital, Kastamonu, Türkiye

Background: The management of hemorrhage from duodenal varices remains controversial. Available treatment methods include endoscopic, radiological, and surgical techniques, with endoscopic therapy being the most commonly used modality.
Case Report: We describe a case of a patient who underwent band ligation for large duo-denal varices. Hemostasis was achieved for forty-eight hours, but the patient later suffered from severe rebleeding. Tragically, the patient passed away after surgical salvage treatment due to decompensation and infection.
Conclusion: In light of a review of pertinent literature, we advise against the sole use of endoscopic band ligation for large varices. It should be complemented with other treatment modalities, ideally radiological interventions such as transjugular intrahepatic porto-systemic shunt or transvenous obliteration.

Keywords: Duodenal varices, ectopic varices, endoscopic band ligation, transjugular intra-hepatic portosystemic shunt, transvenous obliteration.

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