2021 Volume 54 Issue 2 Pages 91-97
The patient was a 36-year-old man with chief complaints of melena and syncope. He had anemia and decreased blood pressure, and underwent emergency upper gastrointestinal endoscopy. A hemorrhagic varix was found in the descending part of the duodenum. It was difficult to stop bleeding by endoscopy and balloon-occluded retrograde transvenous obliteration (B-RTO); therefore, laparotomy was performed in a hybrid operating room. The varix was ligated together with the duodenal wall, and no blood transfer to the varicose vein was confirmed by intraoperative endoscopy and interventional radiology. This case is a rare example of an isolated duodenal varix with no underlying disease such as liver cirrhosis or findings suggestive of portal hypertension. Endoscopy and interventional radiology are the first-line treatments for varices, but surgery is indicated in cases with difficulty with hemostasis, and performance of this surgery in a hybrid operating room may be useful.
