十二指腸静脈瘤出血の1例

抄録

A 58-year-old female was admitted because of hematoemesis and melena. Endoscopic examination was performed down to the 2nd portion of the duodenum but did not disclose obvious bleeding site. The gastrointestinal hemorrhage recurred and the patient became shock. Endoscopic examination eventually revealed duodenal varices at the angle of descending and horizontal portion of the duodenum. We tried to control bleeding with cyanoacrylate injection, but rebled two days later. Endoscopic variceral ligation was performed and it was successful for hemostasis.
It seems to be necessary to perform endoscopic examination down to horizontal portion of the duodenum if upper gastroenterological bleeding is suspected and no obvious bleeding site is defined, especially in the case of portal hypertension. For a further therapy, more discussion about choices is needed.