Case report

Severe bleeding from esophageal varices resistant to endoscopic treatment in a non cirrhotic patient with portal hypertension

Roberto Caronna¹ , Mario Bezzi^1,2 , Monica Schiratti¹ , Maurizio Cardi¹ , Giampaolo Prezioso¹ , Michele Benedetti¹ , Federica Papini¹ , Simona Mangioni¹ , Gabriele Martino¹ and Piero Chirletti¹

¹Department of Surgery "Francesco Durante" – General Surgery N, Sapienza University of Rome, Viale del Policlinico, 00161, Rome, Italy

²Department of Radiology, Sapienza University of Rome, Viale del Policlinico, 00161, Rome, Italy

author email corresponding author email

World Journal of Emergency Surgery 2008, 3:24doi:10.1186/1749-7922-3-24

Published:	21 July 2008

Abstract

A non cirrhotic patient with esophageal varices and portal vein thrombosis had recurrent variceal bleeding unsuccessfully controlled by endoscopy and esophageal transection. Emergency transhepatic portography confirmed the thrombosed right branch of the portal vein, while the left branch appeared angulated, shifted and stenotic. A stent was successfully implanted into the left branch and the collateral vessels along the epatoduodenal ligament disappeared. In patients with esophageal variceal hemorrhage and portal thrombosis if endoscopy fails, emergency esophageal transection or nonselective portocaval shunting are indicated. The rare patients with only partial portal thrombosis can be treated directly with stenting through an angioradiologic approach.