Skip to main content
SpringerLink
Log in

A case of ruptured duodenal varices and review of the literature

  • Case Reports
  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

The incidence of duodenal varices is exceedingly rare. A case of bleeding duodenal varices located in the third portion of the duodenum, secondary to idiopathic portal hypertension, which was successfully treated by surgery, is presented herein. Diagnosis was suspected at superior mesenteric angiography and was subsequently confirmed by endoscopy. A review of the literature reveals only 105 such cases in the world. While the duodenal bulb is the most common site of duodenal varices, the second portion of the duodenum appears to be the next most common site but duodenal varices in the other portions are extremely rare. From all of the possible causes of duodenal varices, liver cirrhosis remains the predominant etiological factor in 31 cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alberti W. Über den röntgenologischen Nachweise von Varizen in Bulbus duodeni. Forschr Geb Röntgenstr 1931; 43: 60–65.

    Google Scholar 

  2. Wilson SE, Stone RT, Christie JP, Passaro E. Massive lower gastrointestinal bleeding from intestinal varices. Arch Surg 1979; 114: 1158–1161.

    PubMed  CAS  Google Scholar 

  3. Levy TS, Hardin JH, Shipp H, Keeling JH. Varices of cecum as an unusual cause of gastrointestinal bleeding. Gastroenterology 1957; 33: 637–640.

    PubMed  CAS  Google Scholar 

  4. Feldman M Jr, Smith VM, Warner CG. Varices of the colon. JAMA 1962; 179: 729–730.

    PubMed  Google Scholar 

  5. Lopato HI, Berlin L. Colon varices: A rare cause of lower gastrointestinal bleeding. Radiology 1966; 87: 1048–1050.

    Google Scholar 

  6. Alberti W. Über den röntgenologischen Nachweise von Varizen in Bulbus duodeni. Forschr Geb Röntgenstr 1933; 47: 467–469.

    Google Scholar 

  7. Vachon A, Marion P, Morel P, Dissard P. Hémorragies intentinales récidivantes per varices de l’intestin grele avec hypotension portale et splenomegalie type Banti. Societe de gastro-enterologie de la region Lyonnaise 1954; 43: 747–750.

    CAS  Google Scholar 

  8. Wheeler HB, Warren R. Duodenal varices due to portal hypertension from arteriovenous aneurysm. Ann Surg 1957; 146: 229–238.

    Article  PubMed  CAS  Google Scholar 

  9. Olson RW, Hodgson JR, Adson MA. The significance of duodenal deformity in patients with extrahepatic portal obstruction. Radiology 1963; 80: 636–640.

    PubMed  CAS  Google Scholar 

  10. Perchik L, Max TC. Massive hemorrhage from the varices of the duodenal loop in a cirrhotic patient. Radiology 1963; 80: 641–644.

    Google Scholar 

  11. De Shazo CV, Belin RP, Lloyd JF, Walder AI. Varix of the duodenum simulating duodenal tumor. Minn Med 1965; 48: 1501–1503.

    Google Scholar 

  12. Shearburn EW, Cooper DR. Duodenal varices treated by portacaval shunt. Arch Surg 1966; 93: 425–427.

    PubMed  CAS  Google Scholar 

  13. Ritcher RW, Pochaczevsky R. Duodenal varices. Arch Surg 1967; 95: 269–273.

    Google Scholar 

  14. Marquand J, Aillet J. Un cas exceptionnel d’hémorragie digestive haute par rupture de varices duodenales sans signes évidents d’hypertension portale. Mem Acad Chir 1967; 93: 155–158.

    PubMed  CAS  Google Scholar 

  15. Fleming RJ, Seaman WB. Roentgenographic demonstration of unusual extraesophageal varices. Am J Radiol 1968; 103: 281–289.

    CAS  Google Scholar 

  16. Stephan G, Miething R. Röntgendiagnostik varicöser Duodenalveränderugern bei portaler Hypertension. Radiologe 1968; 8: 90–95.

    PubMed  CAS  Google Scholar 

  17. Bateson EM. Duodenal and antral varices. Br J Radiol 1969; 42: 744–747.

    Article  PubMed  CAS  Google Scholar 

  18. Knetsch A. Das Rontgenbild der Varicen in Bulbus duodeni. Radiologe 1970; 10: 323–326.

    PubMed  CAS  Google Scholar 

  19. Greenspan A, Bryk D. Duodenal varices secondary to inferior vena obstruction. Dige Dis 1973; 18: 983–986.

    Article  CAS  Google Scholar 

  20. Kunisaki T, Someya N, Shimokawa Y, Okuda K. Varices in distal duodenum seen with a fiber-duodenoscope. Endoscopy 1973; 5: 101–104.

    Google Scholar 

  21. Buysschaert M, Lebrec D, Regensberg M, Nahum H, Behamou JP. Hémorragie digestive par rupture de varices duodenales. Arch Fr Mal App Dig 1976; 65: 481–485.

    PubMed  CAS  Google Scholar 

  22. Kunert H, Ottenjann R. Endoscopy in bleeding duodenal varices. Endoscopy 1976; 8: 99–101.

    Google Scholar 

  23. Richardson JD, McInnis WD, Pestana C. Duodenal varices. Am Surg 1976; 42: 201–203.

    PubMed  CAS  Google Scholar 

  24. Itzchak Y, Glickman MG. Duodenal varices in extrahepatic portal obstruction. Radiology 1977; 124: 619–624.

    PubMed  CAS  Google Scholar 

  25. Lynch C, Maunz DL. Gastroduodenal varices secondary to splenic vein thrombosis. J Maine Med Associat 1977; 68: 455–457.

    Google Scholar 

  26. Schoettle GP, Davis WD, Bowen JC. Duodenal varices: A rare case of upper gastrointestinal hemorrhage. J Louisiana State M Soc 1978; 130: 7–10.

    Google Scholar 

  27. Salam A, Goldman M, Smith D, Hill L. Gastric, intestinal, and gallbladder varices: Hemodynamic and therapeutic consideration. South Med J 1979; 72: 402–408.

    PubMed  CAS  Google Scholar 

  28. Aagaard J, Burcharth F. Bleeding duodenal varices demonstrated by transhepatic portography. Acta Chir Scand 1980; 146: 77–78.

    PubMed  CAS  Google Scholar 

  29. Royal HD, Papanicolaou N, Bettmann M, McNeil B. Scintigraphic identification of bleeding duodenal varices. Am J Gastroent 1980; 74: 173–175.

    PubMed  CAS  Google Scholar 

  30. Rappazzo JA, Kozarek RA, Altman M. Duodenal varices: Endoscopic diagnosis of an unusual source of upper gastrointestinal hemorrhage. Gastroint Endoscopy 1981; 27: 227–228.

    CAS  Google Scholar 

  31. Sauerbruch T, Weinzierl M, Dietrich HP, Antes G, Eisenburg J, Paumgartner G. Sclerotherapy of a bleeding duodenal varix. Endoscopy 1982; 14: 187–189.

    Article  PubMed  CAS  Google Scholar 

  32. Hellstrom HR, Horvat BL, McCoy MM. Duodenal varices with cirrhosis of the liver: Report of three cases. Am Surg 1973; 39: 518–521.

    PubMed  CAS  Google Scholar 

  33. Nakayama M, Kamuro Y, Sagara K, Sato T, Tagami K, Tashiro S. A case of bleeding duodenal varices located in the third portion. Gastroent Jap 1983; 18: 599–602.

    CAS  Google Scholar 

  34. Speche RAJ, Roy AD. Bleeding duodenal varices. Br J Surg 1984; 71: 588.

    Google Scholar 

  35. Gushurst TP, Lesesne HR, Hill C. Isolated duodenal varices: An unusual cause of gastrointestinal hemorrhage. South Med J 1984; 77: 915–918.

    PubMed  CAS  Google Scholar 

  36. Amin R, Alexis R, Korzis J. Fetal ruptured duodenal varix: A case report and review of literature. Am J Gastroent 1985; 80: 13–18.

    PubMed  CAS  Google Scholar 

  37. Schwartz SL. Surgical disease of the liver. New York: McGraw-Hill 1964; 291–294.

    Google Scholar 

  38. Swart VD. Zur Entwicklungssystematik van Ösophagus-, Magen-, und Duodenalvarizen bei portaler Hypertension. Fortschr Geb Röntgenstr Nuklearmed 1968; 108: 184–197.

    Article  PubMed  CAS  Google Scholar 

  39. Rousselot LM, Panke WF. Studies on portal hypertension IV. The clinical and physiologic significance of selfestablished (nonsurgical) portal systemic venous shunts. Ann Surg 1959; 150: 384–412.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Emergency Care Unit, Kansai Medical University, Moriguchi, 1 Fumizono-cho, Moriguchi, 570, Osaka, Japan

    Takaya Tanaka MD, Kenichi Kato, Tomoyuki Taniguchi, Daisuke Takagi, Naoshi Takeyama & Yasuhide Kitazawa

Authors
  1. Takaya Tanaka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenichi Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomoyuki Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daisuke Takagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naoshi Takeyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasuhide Kitazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tanaka, T., Kato, K., Taniguchi, T. et al. A case of ruptured duodenal varices and review of the literature. The Japanese Journal of Surgery 18, 595–600 (1988). https://doi.org/10.1007/BF02471496

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02471496

Key Words

Search

Navigation