Korean Journal of Gastrointestinal Endoscopy 2008;37(1): 76-81.
췌장암 환자에서 담관 금속 스텐트 유치 후 발생한 방유두 십이지장 정맥류 출혈 1예
이충훤*ㆍ정석*ㆍ이돈행*,†
*인하대학교 의과대학 내과학교실, †BK21 사업단
A Case of Bleeding from a Periampullary Duodenal Varix that Developed after Biliary Metal Stent Placement in a Patient with Pancreatic Cancer
Chung Hwon Lee, M.D.*, Seok Jeong, M.D.* and Don Haeng Lee, M.D.*,†
*Department of Internal Medicine, †Center for Advanced Medical Education by Brain Korea 21 Project, Inha University College of Medicine, Incheon, Korea
Abstract
Duodenal varices bleed less commonly than gastro-esophageal varices in patients with portal hypertension. However, if there is no stigmata of recent esophageal or gastric variceal bleeding, clinicians should suspect the presence of an extra gastro-esophageal site of variceal bleeding. Duodenal variceal bleeding can be difficult to diagnose and treat. Therefore, the bleeding may be life threatening in most cases and has a poor prognosis. We experienced a case of variceal bleeding that developed in a patient with far advanced pancreatic cancer after placement of a self- expanding metal stent into a strictured bile duct via the peroral and transpapillary route. The patient had a duodenal varix near the major papilla and the bleeding was treated with an injection of HistoacrylⰒ. We thought the bleeding of the periampullary varix resulted from injury due to exposure to the free end of the alloy wires in the distal portion of the inserted biliary metal stent. (Korean J Gastrointest Endosc 2008;37:76-81)
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