Gastrointestinal Haemorrhage Secondary to Ectopic Varices at the Site of Previous Surgery
A Zia, Z Bashir, P Tait
Hong Kong J Radiol 2017;20:e21-7
DOI: 10.12809/hkjr1716903
Ectopic varices are uncommon but potentially life-threatening portosystemic venous collaterals. They are high variable and can occur anywhere across the gastrointestinal tract, except for the pathological sites for portoportal or portosystemic varices. Ectopic varices are responsible for 1% to 5% of all gastrointestinal haemorrhage cases, and their bleeding risk is four times that of oesophageal varices. Patients may present acutely with massive upper or lower gastrointestinal bleeding and consequent shock or chronically with anaemia of unknown origin. First-line diagnostic tests include contrast-enhanced computed tomography, gastrointestinal endoscopy, and angiography. Ectopic varices can be an incidental finding on laparotomy and at autopsy. Mortality can be as high as 40% when associated with severe acute haemorrhage. We report three cases of gastrointestinal haemorrhage secondary to ectopic varices at the site of previous surgery.
Authors' affiliations:
A Zia1, Z Bashir2, P Tait1
1Department of Radiology, Hammersmith Hospital, Nottingham, United Kingdom
2Department of Oncology, Hammersmith Hospital, Nottingham, United Kingdom
中文摘要
前手術部位的異位靜脈曲張造成的消化道出血
A Zia, Z Bashir, P Tait
異位靜脈曲張是並不常見但可能危及生命的門體靜脈側枝循環。除了門靜脈-門靜脈或門靜脈-體循環靜脈曲張病理以外，它們表現各異，可以發生在整個胃腸道的任何地方。異位靜脈曲張引致1%至5%的胃腸道出血病例，其出血風險是食道靜脈曲張的4倍。患者可出現急性上 / 下消化道大出血，並引至休克，或慢性表現為不明原因的貧血。一線診斷檢查包括對比增強電腦斷層掃描、胃腸內鏡檢查和血管造影。異位靜脈曲張也可以為一種在剖腹手術和屍檢的偶然發現。如有嚴重急性出血其死亡率可高達40%。我們報告了三例在前手術部位的異位靜脈曲張造成的消化道出血。