Two Successfully Treated Cases with Ruptured Duodenal Varices

Yoshito Ogura¹⁾, Teruhiko Watanabe¹⁾, Gen Tanabe¹⁾, Hisaaki Shimazu¹⁾, Mineo Tabata²⁾, Juro Mizouchi²⁾, Koro Sakoda²⁾, Takeshi Yano³⁾, Masahiro Ohsako⁴⁾, Sadao Tanaka⁴⁾

First Department of Surgery, Kagoshima University School of Medicine¹⁾
Department of Surgery²⁾, Department of Radiology³⁾, and Department of Pathology⁴⁾
Kagoshima Medical Association Hospital

Two successfully treated patients with ruptured duodenal varices are described. Case l was a 50-year-old man admitted to our hospital with a complaint of massive melena. Upper gastrointestinal examination revealed a lesion showing meandering prominence on the anterior wall of the first portion of the duodenum. Angiographic study demonstrated an obstruction of the portal vein and dilated tortuous veins along the duodenum. From these findings, the lesion was diagnosed as duodenal varices, and suture-ligation of the varices was performed under laparotomy. Case 2 was a 69-year-old woman after suffering from liver disease for a long time, she presented with hematemesis and melena. Endoscopic examination revealed an actively bleeding lesion showing a meandering prominence at the second portion of the duodenum. The diagnosis was ruptured duodenal varices, and endoscopic sclerotherapy was conducted. As the procedure produce hemostasis, devascularization of the duodenum was surgically performed. The postoperative course of the 2 patients was uneventful, and no serious events have occurred in the two years or more since surgery.

Key words
duodenal varices, portal hypertension, gastrointestinal bleeding

Reprint requests
Yoshito Ogura First Department of Surgery, School of Medicine, Kagoshima University
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
April 14, 1993

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