Multimodal therapy of recurrent and refractory bleeding from esophageal varices - case report and review of the literature.
Z Gastroenterol
; 54(12): 1320-1326, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27875848
ABSTRACT
Bleeding from esophageal varices is a major cause of mortality in patients with advanced liver disease. Although standard treatment and secondary prophylaxis are effective, in some patients sustained hemostasis cannot be achieved. We report the case of a woman with alcoholic liver disease in whom pharmacological, endoscopic, and intravascular therapies failed to control variceal bleeding. Only a combination of (repeated) band ligation, insertion of a self-expanding metal stent, TIPS implantation and redilatation, transjugular variceal embolization, and finally implantation of a portocaval shunt proved to be successful. We discuss the stepwise approach to this situation and the challenges encountered in the process.
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Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Varizes Esofágicas e Gástricas
/
Stents
/
Angioplastia com Balão
/
Derivação Portossistêmica Transjugular Intra-Hepática
/
Embolização Terapêutica
/
Hemorragia Gastrointestinal
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Revista:
Z Gastroenterol
Ano de publicação:
2016
Tipo de documento:
Article