Case ReportsTransjugular intrahepatic portosystemic shunt for bleeding angiodysplasia-like lesions in portal-hypertensive colopathy☆
Section snippets
Case report
A 75-year-old woman was admitted to our department for further evaluation of recurrent anorectal bleeding.
The patient had been asymptomatic until 11 months earlier when she experienced repeated upper GI bleeding (five distinct episodes) that required esophageal sclerotherapy. She was treated with a nonselective β-blocker (propranolol, 25 mg twice a day) to prevent further upper GI bleeding. A diagnosis of liver cirrhosis caused by chronic active hepatitis B was made. A history of infection
Discussion
Patients with portal hypertension may bleed from variceal portosystemic collaterals or specific nonvariceal lesions.
Varices can occur along the entire GI tract. Most commonly they are found as esophageal or gastric varices frequently causing upper GI bleeding.18 Besides the description of portal-hypertensive gastropathy, few data are available on portal-hypertensive intestinal vasculopathy involving small bowel (enteropathy) and the colon (colopathy).12, 19, 20, 21, 22, 23 Although PHC is
References (40)
- et al.
Anorectal varices, hemorrhoids, and portal hypertension
Lancet
(1989) - et al.
The prevalence and spectrum of colonic lesions in patients with cirrhotic and noncirrhotic portal hypertension
Hepatology
(1995) - et al.
Portal colopathy: prospective study of colonoscopy in patients with portal hypertension
Gastroenterology
(1991) - et al.
The role of transjugular intrahepatic portosystemic shunt for treatment of portal hypertension and its complications: a conference sponsored by the National Digestive Diseases Advisory Board
- et al.
Gastroesophageal endoscopic features in cirrhosis
Gastroenterology
(1990) - et al.
Gastric mucosal vascular ectasias causing bleeding in cirrhosis: a distinct entity associated with hypergastrinemia and low serum levels of pepsinogen I
Gastroenterology
(1987) - et al.
Relationship of portal pressure, anorectal varices and hemorrhoids in cirrhotic patients
J Hepatol
(1992) - et al.
The treatment of portal hypertension: a meta-analytic review
Hepatology
(1995) - et al.
Duodenal varices in extrahepatic portal obstruction
Radiology
(1977) - et al.
Hemorrhage from a portal-systemic venous shunt with unusual localisation in a case of portal hypertension
Scand J Gastroenterol
(1974)
Recurrent bleeding from anorectal varices: successful treatment with a transjugular intrahepatic portosystemic shunt
Am J Gastroenterol
Rezidivierende Kolonvarizenblutung bei portaler Hypertonie. Erfolgreiche Rezidiv-Prophylaxe durch Implantation eines transjugulären intrahepatischen Stent-Shunt (TIPS)
Dtsch Med Wochenschr
Bleeding anorectal varices: successful treatment with transjugular intrahepatic portosystemic shunting
Gut
Bleeding anorectal varices—a misunderstood condition
Surgery
Endoscopic sclerotherapy for bleeding rectal varices: a case report
Am J Gastroenterol
Portal hypertensive colopathy in patients with cirrhosis
Scand J Gastroenterol
Prevalence and factors influencing hemorrhoids, anorectal varices, and colopathy in patients with portal hypertension
Endoscopy
Portal hypertensive gastric mucosa: an endoscopic study
Gut
A randomized controlled study of propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a final report
Hepatology
The role of propranolol in congestive gastropathy of portal hypertension
Hepatology
Cited by (0)
- ☆
Address requests for reprints to: Wolfgang E. Fleig, M.D., First Department of Medicine, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097 Halle/Saale, Germany. Fax: (49) 345-5572253.