| Theme | Endoscopic Treatment of Upper Gastrointestine: Current Status and Clinical Problems | |
|---|---|---|
| Title | Problems with Treatment for Ectopic Varices with Portal Hypertension | |
| Publish Date | 2004/09 | |
| Author | Katsutoshi Obara | Department of Internal Medicine II, Fukushima Medical University School of Medicine |
| [ Summary ] | In patients with portal hypertension, esophago-gastric varices develop in conjuction with collateral circulation. Treatment of esophago-gastric varices will change the direction of the collateral blood flow and cause ectopic varices to occur. Therefore, ectopic varices should be recognized as the cause of the gastrointestinal bleeding. This review, examines duodenal varices, and describes their pathology and treatment. The most common disease associated with duodenal varices is liver cirrhosis or extrahepatic portal obstructions (EHO). However portal circulation differs between liver cirrhosis and EHO. Therefore, treatment for duodenal varices must be performed according to each type of portal circulation. There are nonsurgical treatments (endoscopic treatments, treatments using IVR) and surgical treatments for bleeding duodenal varices. However the guidelines for treatment of duodenal varices is not well established. |
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