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Duodenal dearterialization and stapling for severe hemorrhage from duodenal varices with portal vein thrombosis.
Am J Surg. 2005 Jan; 189(1):49-52.AJ

Abstract

BACKGROUND

Hemorrhage from duodenal varices is a rare but frequently fatal cause of gastrointestinal bleeding. Portal vein thrombosis may worsen the bleeding and prevent access for reduction of variceal pressure.

METHODS

A technique to control bleeding and reduce inflow pressure to the varices is described. It includes ligation of the gastroduodenal and splenic arteries, splenectomy, stapling of the duodenum, and gastroenterostomy.

RESULTS

Three patients, hemodynamically unstable from duodenal hemorrhage, underwent the procedure. No further bleeding was encountered. One patient died of fungal sepsis and liver failure, but 2 are alive without further problems 21 and 24 months later.

CONCLUSIONS

Reduction in arterial inflow, direct variceal ligation, reversal of hypersplenism, and food stream diversion are elements of this procedure that may have contributed the control of severe hemorrhage from duodenal varices associated with portal vein thrombosis.

Authors+Show Affiliations

Department of Surgery, 4TU-44, University Hospital, London, Ontario, Canada N6A 5A5. vmcalist@uwo.caNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15701491

Citation

McAlister, Vivian C., and Noha A. Al-Saleh. "Duodenal Dearterialization and Stapling for Severe Hemorrhage From Duodenal Varices With Portal Vein Thrombosis." American Journal of Surgery, vol. 189, no. 1, 2005, pp. 49-52.
McAlister VC, Al-Saleh NA. Duodenal dearterialization and stapling for severe hemorrhage from duodenal varices with portal vein thrombosis. Am J Surg. 2005;189(1):49-52.
McAlister, V. C., & Al-Saleh, N. A. (2005). Duodenal dearterialization and stapling for severe hemorrhage from duodenal varices with portal vein thrombosis. American Journal of Surgery, 189(1), 49-52.
McAlister VC, Al-Saleh NA. Duodenal Dearterialization and Stapling for Severe Hemorrhage From Duodenal Varices With Portal Vein Thrombosis. Am J Surg. 2005;189(1):49-52. PubMed PMID: 15701491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Duodenal dearterialization and stapling for severe hemorrhage from duodenal varices with portal vein thrombosis. AU - McAlister,Vivian C, AU - Al-Saleh,Noha A, PY - 2003/07/31/received PY - 2004/04/23/revised PY - 2004/04/23/accepted PY - 2005/2/11/pubmed PY - 2005/3/19/medline PY - 2005/2/11/entrez SP - 49 EP - 52 JF - American journal of surgery JO - Am J Surg VL - 189 IS - 1 N2 - BACKGROUND: Hemorrhage from duodenal varices is a rare but frequently fatal cause of gastrointestinal bleeding. Portal vein thrombosis may worsen the bleeding and prevent access for reduction of variceal pressure. METHODS: A technique to control bleeding and reduce inflow pressure to the varices is described. It includes ligation of the gastroduodenal and splenic arteries, splenectomy, stapling of the duodenum, and gastroenterostomy. RESULTS: Three patients, hemodynamically unstable from duodenal hemorrhage, underwent the procedure. No further bleeding was encountered. One patient died of fungal sepsis and liver failure, but 2 are alive without further problems 21 and 24 months later. CONCLUSIONS: Reduction in arterial inflow, direct variceal ligation, reversal of hypersplenism, and food stream diversion are elements of this procedure that may have contributed the control of severe hemorrhage from duodenal varices associated with portal vein thrombosis. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/15701491/Duodenal_dearterialization_and_stapling_for_severe_hemorrhage_from_duodenal_varices_with_portal_vein_thrombosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(04)00490-8 DB - PRIME DP - Unbound Medicine ER -