Intestinal Bleeding from Ileal Mesenteric Varices with Wilson's Disease

Hiroaki Okuyama, Shingo Iwata, Kazutaka Obama, Hitoshi Tanaka, Hiroki Hashida, Yoshiaki Nakamura, Atsuhiko Maki, Arimichi Takabayashi

Department of Surgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute

We report a rare case of ileal mesenteric varices with Wilson's disease. A 28-year-old woman diagnosed as having Wilson's disease who had been treated by penicillamine and trientine for 10 years was admitted to the hospital because of recurrent melena. Abdominal angiography revealed ileal mesenteric varices shunting to the right ovarian vein. We partially resected the ileum including the varices without any additional decompression surgery. The portal vein pressure was 20 cmH₂O. The patient showed no problems 15 months after the operation. We suspected that the pathogenesis of the mesenteric varices in this case was related to a previous appendectomy.

Key words
ileal varices, mesenteric varices, Wilson's disease

Reprint requests
Hiroaki Okuyama Department of Surgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute
13-3 kamiyama-cho, Kita-ku, Osaka, 530-0026 JAPAN

Accepted
September 16, 1998

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