Jejunal variceal bleeding after esophageal transection in a patient with idiopathic portal hypertension.

Abstract

This report describes a 38-year-old man with massive gastrointestinal bleeding from jejunal varices. He had been previously diagnosed to have idiopathic portal hypertension and esophageal varices, and had undergone an esophageal transection 8 years earlier. The pre-operative diagnosis was a suspected hemorrhage from the small intestine as visualized by 99mTc-HSAD scintigraphy (technetium 99m-labeled human serum albumin D-type) and was not considered to be repeated massive lower GI tract bleeding. An exploratory laparotomy was performed, and intra-operative endoscopy revealed active bleeding from the jejunal varices. A partial resection of the small intestine resulted in a complete resolution of the bleeding. A review of the literature thereafter disclosed twelve previously reported cases of jejunal variceal bleeding.

• Authors: S Migou, M Hashizume, K Tsugawa, F Kishihara, H Kawanaka, M Ohta, K Tanoue, T Kuroiwa, K Kawamoto, K Sugimachi
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 1998 Mar-Apr Vol. 45 Issue 20 Pg. 503-7 ISSN: 0172-6390 [Print] Greece
• PMID: 9638437 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Aggregated Albumin

Topics

• Adult
• Esophageal and Gastric Varices (surgery)
• Gastrointestinal Hemorrhage (diagnostic imaging, etiology)
• Humans
• Hypertension, Portal (complications)
• Jejunum (blood supply, diagnostic imaging)
• Male
• Radionuclide Imaging
• Radiopharmaceuticals
• Technetium Tc 99m Aggregated Albumin
• Time Factors
• Varicose Veins (diagnostic imaging, etiology)