Outcome of patients with ruptured ectopic varices

Abstract

Ectopic varices have been increasing in recent years due to improvement of outcome of patients with esophageal and gastric varices, in whom endoscopic therapies and/or interventional radiology treatment were done. However, the treatment strategy for ectopic varices has not yet been established. In this study, we evaluated the outcome of 22 patients with ruptured ectopic varices receiving therapies for a total of 41 variceal lesions in our hospital; 6 lesions in the duodenum, 5 lesions in the postoperative anastomosis, 6 lesions in the rectum, 2 lesions in the small intestine, 1 lesion in the ascending colon, and 2 lesions in the stoma. Initial hemostasis was obtained in all the patients, while rebleeding occurred frequently in patients with varices in the anastomosis, rectum, and stoma. Recently, endoscopic sclerotherapy using cyanoacrylate (HA-EIS) has been done for patients with bleeding varices. In our hospital, 16 patients received HA-EIS. And the patient with varices in the duodenum and ascending colon, the feeding veins were successfully embolized in 5 patients. Thus, endoscopic therapies should be done in patients with ruptured ectopic varices to obtain initial hemostasis, and HA-EIS merits consideration in a part of patients to obtain a favorable outcome in whom adequate embolization of the feeding veins was achieved.