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Isolated ectopic jejunal varices in a patient with extrahepatic portal vein obstruction - A case report.

Authors
  • Solanki, Sanket1
  • Jena, Suvendu Sekhar2
  • Das, Sri Aurobindo Prasad2
  • Yadav, Amitabh2
  • Mehta, Naimish N2
  • Nundy, Samiran2
  • 1 Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, Delhi 110060, India. Electronic address: [email protected] , (India)
  • 2 Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, Delhi 110060, India. , (India)
Type
Published Article
Journal
International Journal of Surgery Case Reports
Publisher
Elsevier
Publication Date
Sep 01, 2021
Volume
86
Pages
106299–106299
Identifiers
DOI: 10.1016/j.ijscr.2021.106299
PMID: 34419724
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Among the various causes for lower gastrointestinal bleeding, ectopic varices constitute a small chunk. Though rare, these can pose a diagnostic challenge with recurrent bleed leading to multiple admission and blood transfusions. A 41-year-old male presented to our department with multiple episodes of melena. On further evaluation with CT angiography, a diagnosis of extrahepatic portal vein obstruction with moderate splenomegaly and ectopic jejunal varix was made. He underwent splenectomy with resection of involved jejunal segment with side to side anastomosis. The diagnosis of ectopic varices remains elusive in a large number of cases in view of the varied etiology. Various newer endoscopic and imaging modalities can play a diagnostic as well as therapeutic role but this also further complicates the management as there is a lack of substantial guidelines directing the treatment protocol. As a result, we have to resort to a case by case approach for the optimal management in these cases. The main modality of management for bleeding ectopic varices is percutaneous or endoscopic. Surgery is reserved for refractory cases, with decompressive shunts combined with segmental resection of involved intestine being at the forefront of surgical options. Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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