Authors: J. Mendl; F. Křivan Authors‘ workplace: Chirurgické oddělení Městské Nemocnice Mariánské Lázně, primář: MUDr. J. Švec Published in: Rozhl. Chir., 2007, roč. 86, č. 6, s. 303-305. Category: Monothematic special - Original
Portal hypertension is very often complicated by severe and a life threatening bleeding in GIT in most cases from oesophageal varices. Another complication of PH is dilatation of portosystemic shunts in abdominal wall so-called caput medusae. We describe a case of a man, that was admitted to our surgical department with massive bleeding from recanalisated umbilical vein as complication of portal hypertension. After couple of the recurrence of the haemorrhage and precise diagnosis of the source we have indicated surgical treatment. We cat off the lig. teres hepatis by laparoscopic approach to decrease tension in blood vessels in the abdominal wall. After surgery there were no evidence of rebleeding and the patient was forwarding for monitoring of oesophageal varices in gastroenterological center.
Key words: massive bleeding – umbilical vein – portal hypertension
1. Vidal, V., Joly, L., Perreault, P., Bouchard, L., Lafortune, M, Pomier-Layrargues, G. Usefulness of transjugular intrahepatic portosystemic shunt in the management of bleeding ectopic varices in cirrhotic patients. Cardiovasc. Intervent. Radiol., 2006, Mar-Apr; 29(2): 216–219.
2. Fitzgerald, J. B., Chalmers, N., Abbott, G., Lee, S. H., Warnes, T. W., Youngs, G. R., Wardle, T. D. The use of TIPS to control bleeding caput medusae. Br. J. Radiol., 1998, May; 71(845): 558–560.
3. Douglas, J. G. Umbilical haemorrhage-an unusual complication of cirrhosis. Postgrad. Med. J., 1981, Jul; 57(669): 461–462.
4. Lewis, C. P., Murthy, S., Webber, S. M., Chokhavatia, S. Hemorrhage from recanalized umbilical vein in a patient with cirrhosis. Am. J. Gastroenterol., 1999, Jan; 94(1): 280.
5. Harish, K., Harikumar, R., Kumar, R. S., Sandesh, K., Rajendran, V., Thomas, V. Umbilical hemorrhage as first manifestation in a case of cirrhosis. Trop. Gastroenterol., 2005, Apr-Jun; 26(2): 93–94.
6. Basu, A., Sistla, S. C., Jagdish, S. Laparoscopic control of spontaneous external hemorrhage from umbilical varix. Indian J. Gastroenterol., 2006, Jul-Aug; 25(4): 211–212.
Don‘t have an account? Create new account
Enter the email address that you registered with. We will send you instructions on how to set a new password.
