Duodenal Variceal Bleeding Treated with a Combination of Endoscopic Ligation and Injection Sclerotherapy: Two Case Reports and a Review of the Korean Clinical Literature / 대한소화기내시경학회지

ABSTRACT

A duodenal varix is a rare cause of hemorrhage in patients with intrahepatic and extrahepatic portal hypertension. However, bleeding in these patients is serious and often life threatening. Treatments for duodenal variceal bleeding include endoscopic injection sclerotherapy, endoscopic ligation, surgical procedures and interventional radiology. We report two cases of duodenal variceal bleeding in a 53- year-old male patient and a 63-year-old female patient with liver cirrhosis that presented with hematemesis and melena. Emergency upper endoscopy examinations revealed the presence of large nodular varices with ruptured erosion on the top of the second portion of the duodenum. A combination of the use of endoscopic ligation and endoscopic injection sclerotherapy was performed and successful hemostasis and eradication of duodenal varices was possible in all cases. Another 19 cases of duodenal variceal bleeding that have been reported in the Korean clinical literature were reviewed.