Endoscopic band ligation of a proximal duodenal varix; Case report (with video)

Abstract

Duodenal varices are a rare consequence of portal hypertension, which constitute 17% of ectopic varices, if these varices bleed, the mortality is around 40%. Medical therapies, including vasopressin, have limited success in controlling active duodenal variceal bleeding. We present a case of a 52 y-o woman who presented with hematochezia and deep anemia requiring multiple transfusions. She has a history of being diagnosed with cirrhosis, FMF, hemochromatosis and factor V Leiden mutation with multiple deep vein thrombosis. The abdomen computer tomography (CT) revealed active bleeding vat the proximal duodenum. She underwent emergent esophagogastroduodenoscopy, which showed actively pulsatile bleeding duodenal varices. Endoscopic hemostasis was achieved successfully with variceal band ligation. Endoscopic band ligation is an effective intervention for actively bleeding duodenal varices, especially for those located in the proximal duodenum, which were more accessible endoscopically than the distal ones.

Keywords

• varix
• duedenum
• bleeding
• liver
• cirrhosis

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