Korean Journal of Gastrointestinal Endoscopy 1999;19(2): 281-286.
TIPS (Transjugular Intrahepatic Portosystemic Shunt)로 치료된 십이지장 정맥류 출혈 (Duodenal Variceal Bleeding Treated with a Transjugular Intrahepatic Portosystemic Shunt)
김인한, 이돈행, 신현주, 장재남, 유종길, 최원, 김범수, 김형길, 김영수, 강성권 (In Han Kim, Don Haeng Lee, Hyun Joo Shin, Jae Nam Chang, Jong Gil Yoo, Won Choi, Pum Soo Kim, Hyung Gil Kim, Young Soo Kim and Sung Gwon Kang)
Abstract
Most cases of upper gastrointestinal bleeding in patients with portal hypertension are caused by esophagogastric varices. Less often, bleeding originates in varices located elsewhere. If ectopic varices are found, the same hemostatic technique tend to be used. However, there is no evidence that such techniques are useful in these cases. Duodenal varices are quite common, although they rarely bleed due to their location deep in the duodenal wall. Consequently, if emergency endoscopy is not conducted, hemorrhage may be wrongfully attributed to coexisting esophagogastric varices in a patient with portal hypertension without active bleeding. Hemorrhage from duodenal varices may be severe and life threatening. We report a patient with portal hypertension and bleeding duodenal varices caused by cirrhosis of the liver. Hemorrhage was subsequently controlled by placement of a transjugular intrahepatic portosystemic shunt. We recommend that in patients with life-threatening hemorrhage from duodenal varices caused by cirrhosis of the liver, transjugular intrahepatic portosystemic shunt (TIPS) be considered in the man-agement. (Korean J Gastrointest Endosc 19: 281 ∼286, 1999)
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