Intra-abdominal Hemorrhage from Ruptured Retroperitoneal Varices

Shoji Uetsuji, Masashi Okamoto, Manabu Yamamura, Keigo Yamaichi, Masahito Sato, Koshiro Hioki, Masakatsu Yamamoto

Department of Surgery, Kansai Medical University

The most important complication of portal hypertension is ruptured variceal bleeding, which usually occurs in esophagogastric varices. However, hemoperitoneum can occur as a result of variceal bleeding. We recently experienced a case of hemoperitoneum caused by ruptured variceal bleeding under a portosystemic shunt. The patient was a 65-year-old woman, in whom hemoperitoneum occurred on the tenth day after a pancreaticoduodenectomy. A reoperation was performed immediately, because of ectopic variceal bleeding, and the ruptured varices were ligated and a splenorenal shunt was made. In case of hemoperitoneum, we should consider ectopic varical bleeding too, and immediately ligate the ruptured varices.

Key words
hemoperitoneum, intra-abdominal varices, liver cirrhosis

Reprint requests
Shoji Uetsuji Department of Surgery, Kansai Medical University
1 Fumizonocho, Moriguchi, 570 JAPAN

Accepted
February 13, 1991

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