Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma
Ectopic varices are portosystemic collaterals that occur away from the gastroesophageal junction and account for 1-5% of all variceal bleeding. Its occurrence in the jejunum is rare. Most common cause of ectopic jejunal varices is portal hypertension especially in those patients who have undergone p...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/4526472 |
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| author | Ahmad Ayash Kamran Mushtaq Mohamed Emad Abdul Qader Khalid Mohsin Al-Ejji Saad Rashid Al Kaabi Shadi J. S. Khelfa |
| author_facet | Ahmad Ayash Kamran Mushtaq Mohamed Emad Abdul Qader Khalid Mohsin Al-Ejji Saad Rashid Al Kaabi Shadi J. S. Khelfa |
| author_sort | Ahmad Ayash |
| collection | DOAJ |
| description | Ectopic varices are portosystemic collaterals that occur away from the gastroesophageal junction and account for 1-5% of all variceal bleeding. Its occurrence in the jejunum is rare. Most common cause of ectopic jejunal varices is portal hypertension especially in those patients who have undergone prior abdominal surgery. Portomesenteric thrombosis is a rare cause of ectopic jejunal varices. Ectopic varices are rare cause of obscure GI bleeding and hence should be always suspected in patients with history of portal hypertension who present with GI bleeding and have negative upper and lower GI endoscopies. Management of patients with ectopic varices is often very challenging and requires multidisciplinary approach. Therapeutic options include endoscopic therapy, interventional radiologic procedures, surgically creating shunting, or surgical resection. We present the case of a 52-year-old patient who was on anticoagulation for extensive portomesenteric thrombosis secondary to factor V Leiden heterozygous mutation and presented with melena and symptomatic anemia. Investigations showed bleeding jejunal varices as the cause of anemia. We discuss the therapeutic options and dilemma in the management of such cases. |
| format | Article |
| id | doaj-art-0fa05c61e6b3426ba5c2bceb816cd7f8 |
| institution | OA Journals |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-0fa05c61e6b3426ba5c2bceb816cd7f82025-08-20T02:01:40ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362019-01-01201910.1155/2019/45264724526472Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management DilemmaAhmad Ayash0Kamran Mushtaq1Mohamed Emad Abdul Qader2Khalid Mohsin Al-Ejji3Saad Rashid Al Kaabi4Shadi J. S. Khelfa5Department of Gastroenterology, Hamad Medical Corporation, Doha, QatarDepartment of Gastroenterology, Hamad Medical Corporation, Doha, QatarDepartment of Internal Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Gastroenterology, Hamad Medical Corporation, Doha, QatarDepartment of Gastroenterology, Hamad Medical Corporation, Doha, QatarDepartment of Gastroenterology, Hamad Medical Corporation, Doha, QatarEctopic varices are portosystemic collaterals that occur away from the gastroesophageal junction and account for 1-5% of all variceal bleeding. Its occurrence in the jejunum is rare. Most common cause of ectopic jejunal varices is portal hypertension especially in those patients who have undergone prior abdominal surgery. Portomesenteric thrombosis is a rare cause of ectopic jejunal varices. Ectopic varices are rare cause of obscure GI bleeding and hence should be always suspected in patients with history of portal hypertension who present with GI bleeding and have negative upper and lower GI endoscopies. Management of patients with ectopic varices is often very challenging and requires multidisciplinary approach. Therapeutic options include endoscopic therapy, interventional radiologic procedures, surgically creating shunting, or surgical resection. We present the case of a 52-year-old patient who was on anticoagulation for extensive portomesenteric thrombosis secondary to factor V Leiden heterozygous mutation and presented with melena and symptomatic anemia. Investigations showed bleeding jejunal varices as the cause of anemia. We discuss the therapeutic options and dilemma in the management of such cases.http://dx.doi.org/10.1155/2019/4526472 |
| spellingShingle | Ahmad Ayash Kamran Mushtaq Mohamed Emad Abdul Qader Khalid Mohsin Al-Ejji Saad Rashid Al Kaabi Shadi J. S. Khelfa Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma Case Reports in Gastrointestinal Medicine |
| title | Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma |
| title_full | Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma |
| title_fullStr | Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma |
| title_full_unstemmed | Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma |
| title_short | Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma |
| title_sort | jejunal varices bleeding in a patient with extensive portomesenteric thrombosis secondary to factor v leiden mutation a management dilemma |
| url | http://dx.doi.org/10.1155/2019/4526472 |
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