Bleeding Jejunal Varices in a Patient with Extensive Porto- Mesenteric Thrombosis: Clinical Conundrum

Mohammad AL Zoubi1*, Ali Toffaha1, Moamena Elmatbouly1,2, Ahmed Suliman1 and Ahmed Al-Bahrani1

1Department of General Surgery, Hamad Medical Corporation, Qatar
2Weill Cornell Medical College, Qatar

^*Correspondance to: Mohammad AL Zoubi 

 PDF  Full Text DOI: 10.25107/2474-1647.3518

Abstract

Ectopic varices are rare cause of obscure GI bleeding and hence should be always suspected in patients with history of portal hypertension who present with GI bleeding and have negative upper and lower GI endoscopies. We reviewed a case of a 58-year-old patient who presented with melena and symptomatic anemia and was a known case of actor V Leiden heterozygous mutation on long term anticoagulation. Unexpectedly his extensive workup showed; bleeding jejunal varices as the source of his anemia. Patient failed multiple trials of interventional radiology embolization and was managed laparoscopically with small bowel segmental resection and re-anastomosis. Establishing the diagnosis is challenging and management should be through a multidisciplinary approach. We conclude that surgical removal of the involved small bowel is a feasible and safe option in similar patients resistant to other modalities of treatment.

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Cite the article

AL Zoubi M, Toffaha A, Elmatbouly M, Suliman A, Al-Bahrani A. Bleeding Jejunal Varices in a Patient with Extensive Porto-Mesenteric Thrombosis: Clinical Conundrum. Clin Surg. 2022; 7: 3518..