Year 2015 / Volume 107 / Number 9
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Obscure gastrointestinal bleeding in a patient with congenital hepatic fibrosis and Crohn´s disease

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Iolanda Ribeiro, Rolando Pinho, Adélia Rodrigues, Luis Alberto, Carlos Fernandes, João Carvalho,

Abstract
Ectopic varices are portosystemic collaterals in locations other than the gastroesophageal region, accounting for up to 1-5% of all variceal bleeding. Authors report a case of obscure gastrointestinal bleeding because of an ectopic varix in a patient with multiple comorbidities: congenital hepatic fibrosis, autosomal dominant polycystic kidney disease, Crohn´s disease, right hemicolectomy and partial portal thrombosis. The diagnosis was suggested by abdominal Angio-TC and confirmed by capsule endoscopy. Endoscopic treatment was tried by retrograde single-balloon enteroscopy, but the ectopic varix was impossible to reach because an ulcerated ileal stenosis 5cm from the ileocolic anastomosis prevented the progression of the overtube. A Transjugular Intrahepatic Portosystemic Shunt (TIPS) was indicated without recurrence of gastrointestinal bleeding. The authors emphazise the need of an early diagnosis and discuss the different treatment options
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Ribeiro I, Pinho R, Rodrigues A, Alberto L, Fernandes C, Carvalho J, et all. Obscure gastrointestinal bleeding in a patient with congenital hepatic fibrosis and Crohn´s disease. 3579/2014


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Publication history

Received: 25/10/2014

Accepted: 17/11/2014

Published: 29/08/2015

Article revision time: 14 days

Article editing time: 308 days


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