Massive bleeding in portal hypertension − endoscopic, surgical or endovascular management?
Authors:
J. Tornikidis 1; J. Hoch 1; R. Pádr 2; R. Keil 3
Authors‘ workplace:
Chirurgická klinika 2. LF Univerzity Karlovy a FN Motol Praha
přednosta: prof. MUDr. J. Hoch, CSc.
1; Klinika zobrazovacích metod 2. LF Univerzity Karlovy a FN Motol Praha
přednosta: prof. MUDr. M. Roček, CSc.
2; Interní klinika 2. LF Univerzity Karlovy a FN Motol Praha
přednosta: prof. MUDr. M. Kvapil, CSc., MBA
3
Published in:
Rozhl. Chir., 2017, roč. 96, č. 9, s. 390-393.
Category:
Case Report
Overview
Upper gastrointestinal bleeding is a serious and potentially life-threatening abdominal emergency. An important diagnostic goal is to determine the cause and localize the bleeding site(s), which is crucial for choosing an appropriate therapy and consequently also for the long-term result.
Our case report presents a patient with recurrent upper gastrointestinal bleeding where even repeated endoscopic, surgical and endovascular interventions were not sufficient to determinate the cause of bleeding and to save the patient´s life.
Key words:
portal hypertension − hepatic cirrhosis − variceal bleeding − ulcerative bleeding
Sources
1. Courtney MT, Jr, Beauchamp RD, Evers MB, et al. Sabiston textbook of surgery, 18th edition. Surgical complication of cirrhosis and portal hypertension, Phliladelphia 2008:1913−2899.
2. D’Amico G, Franchis R. Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators. Hepatology.2003;38:599–612.
3. Sutton FM. Upper gastrointestinal bleeding in patients with esophageal varices: what is the most common source? Am J Med 1987;83:273–5.
4. García-Villarreal L, Martínez-Lagaares F, Sierra A, et al. Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal rebleeding after recent variceal hemorrhage. Hepatology 1999;29:27–32.
5. Sarin SK, Kumar A, Angus PW, et al. Diagnosis and management of acute variceal bleeding: Asian Pacific Association for Study of the Liver Recommendations. Hepatol Int 2011;5:607–24.
6. Orloff J, Orloff MS, Rambotti M, et al. Three decades of experience with emergency portacaval shunt for acutely bleeding esophageal varices in 400 unselected patients with cirrhosis of the liver. J Am Coll Surg 1995;179:257–72.
7. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646−9.
8. Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med 2010;362:823–32.
9. Henderson JM. Role of distal splenorenal shunt for long term management of variceal bleeading. World J Surg 1994;18:205−10.
10. Tripathi D, Therapondos G, Jackson E, et al. The role of the transjugular intrahepatic portosystemic stent shunt (TIPSS) in the management of bleeding gastric varices: clinical and haemodynamic correlations. Gut 2002;51:270–4.
11. Burroughs AK, Planas R, Svoboda P. Optimizing emergency care of upper gastrointestinal bleeding in cirrhotic patients. Scand J Gastroenterol Suppl. 1998;226:14–24.
12. Dennis MJ. Endoscopic screening for varices in cirrhosis: findings, implications and outcomes. Gastroenterology 2002;122:1620−30.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2017 Issue 9
Most read in this issue
-
Hamartoma of the abdominal cavity and retroperitoneum
– a review and a case report - Current application and future perspectives of capsule colonoscopy
- Pneumoperitoneum after colonoscopy – “to cut or not to cut”
- Diagnosis of early pancreatic cancer and precursor lesions