Abstract
We treated two cases of duodenal varices effectively by endoscopic variceal ligation (EVL) using o-rings. Case l was a 63-year-old male with liver cirrhosis of type c(Child's class, B) who was admitted due to hematemesis and melena. Endoscopic observation revealed F2 varices with positive red color sign in the esophagus and F3 varices in the posterior wall of the inferior duodenal flexura. First, the esophageal varices which was suspected as the source of bleeding was treated by endoscopie injection sclerotherapy (EIS), and, next, the duodenal varices was treated by EVL twice and was disappeared in consequence. Case 2 was a 50-year-old male with alcoholic liver cirrhosis (Child's class, C) who was admitted due to hematemesis and melena. Endoscopic observation revealed F3 varices with red fihrin plug in the posterior wall of the second portion of the duodenum, which was considered to be the source of bleeding. EIS was immediately tried for the treatment of the duodenal variceal bleeding, but it was suspended because of no evidence of varicealography. EVL was performed twice, and the duodenal Varices disappeared. In two cases, no significant complications were encountered and short-term follow up endoscopy showed no reappearance of varices. EVL using o-rings was found to be an effective therapeutic technique for duodenal varices.
