| [ Summary ] |
Duodenal varix is rare disease. However if there is a rupture, it may sometimes be fatal. A diagnosis of duodenal varix must be considered in patients with gastrointestinal bleeding. Almost all cases of duodenal varix have portal venous hypertension, caused by hepatic cirrhosis. Diagnosis is made through duodenal endoscopy and CT scans. Abdominal angiography and transcatheter portography make diagnosis more accurate. Endoscopic diagnosis is sometimes difficult, be cause duodenal varix often occurs at the distal side of the duodenum. Endoscopic screlotherapy, rubber band ligation of the varix transcatheter embolization or operative procedures (porto-systemic shunt operations) are used as first choices therapy. The indications for performing operations should be carefully determined, because patients with this disease usually have liver cirrhosis and their general physical condition is not good. Even after initial hemostasis is obtained, careful follow up studies are necessary, because the recurrence rate is high and bleeding recurrs occasionally. Surgery should be considered, even after hemostasis is achieved through endoscopic screlotherapy, rubber band ligation or transcatheter embolization. |