Article Text

Download PDFPDF
CASE REPORT
Jejunal varices: an unconsidered cause of recurrent gastrointestinal haemorrhage
  1. Caleb Joseph Heiberger1,
  2. Tej Ishaan Mehta1 and
  3. Douglas Yim2
  1. 1 Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA
  2. 2 Department of Interventional Radiology, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota, USA
  1. Correspondence to Tej Ishaan Mehta, tej.mehta{at}coyotes.usd.edu

Abstract

A 78-year-old woman presented with melaenic stool and severe anaemia 4 years after a pancreaticoduodenectomy for adenocarcinoma of the pancreas. Initial workup revealed haemorrhage from the choledochojejunostomy site. Despite multiple endoscopic clips to the region, bleeding reoccurred multiple times over a period of several months. Due to ongoing haemorrhage, her case was urgently presented at the hospital’s multidisciplinary hepatobiliary conference. The contrast-enhanced abdominal CT revealed severe stenosis of the extrahepatic portal vein and large afferent jejunal varices at the choledochojejunostomy, suspected as the cause of her persistent bleed. The recommendation was a percutaneous transhepatic approach for stenting of the portal vein stenosis that resulted in rapid decompression of the jejunal varices and control of her haemorrhage.

  • interventional radiology
  • GI bleeding
  • varices

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Contributors DY performed the case and provided review and editorial assistance. TM provided review and editorial assistance. CJH wrote the case report and discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.