Abstract
We investigated clinical characteristics of patients with ectopic varices. Evaluated were 11 patients in whom endoscopy confirmed duodenal varices (9 patients) and jejunal varices (2 patients). Patient's data were retrospectively analyzed regarding underling diseases, endoscopic appearance, endoscopic treatment, and prognosis. Underling diseases were liver cirrhosis (LC) in 9 patients and postoperative recurrence of common bile duct cancer (CBDC) in 2 patients. Eight patients with LC showed duodenal varices and one remaining patient showed jejunal varices, and 2CBDC patients showed jejunal varices. Number of patients according to positive/negative red color signs and F1/F2/F3 form classification by EGD were 2/7 and 5/3/1, respectively.
After hemodynamic evaluation by MD-CT and EUS, 2 patients received endoscopic injection sclerotherapy (EIS) using cyanoacrylate and ethanolamine oleate because of bleeding and 1 patient received EIS due to the growth of duodenal varices. Two treatments were elective, and remaining one was prophylactic. Complete eradication of varices was obtained by single sesssion of EIS in two of the 3 patients. The remaining one had recurrent bleeding several times, and needed four additional sessions of EIS for the complete eradication. There were neither severe complications, nor death related to variceal bleeding in a follow-up period. In two patients with jejunal varices, double balloon endoscopy detected varices, while previous EGD failed to detect the ones.
