Protein C deficiency related obscure gastrointestinal bleeding treated by enteroscopy and anticoagulant therapy.
World J Gastroenterol
; 21(3): 1024-7, 2015 Jan 21.
Article
in En
| MEDLINE
| ID: mdl-25624741
ABSTRACT
Obscure gastrointestinal bleeding is an uncommonly encountered and difficult-to-treat clinical problem in gastroenterology, but advancements in endoscopic and radiologic imaging modalities allow for greater accuracy in diagnosing obscure gastrointestinal bleeding. Ectopic varices account for less than 5% of all variceal bleeding cases, and jejunal variceal bleeding due to extrahepatic portal hypertension is rare. We present a 47-year-old man suffering from obscure gastrointestinal bleeding. Computed tomography of the abdomen revealed multiple vascular tufts around the proximal jejunum but no evidence of cirrhosis, and a visible hypodense filling defect suggestive of thrombus was visible in the superior mesenteric vein. Enteroscopy revealed several serpiginous varices in the proximal jejunum. Serologic data disclosed protein C deficiency (33.6%). The patient was successfully treated by therapeutic balloon-assisted enteroscopy and long-term anticoagulant therapy, which is normally contraindicated in patients with gastrointestinal bleeding. Diagnostic modalities for obscure gastrointestinal bleeding, such as capsule endoscopy, computed tomography enterography, magnetic resonance enterography, and enteroscopy, were also reviewed in this article.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Varicose Veins
/
Hemostasis, Endoscopic
/
Protein C Deficiency
/
Gastrointestinal Hemorrhage
/
Jejunum
/
Anticoagulants
Type of study:
Diagnostic_studies
/
Etiology_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
World J Gastroenterol
Journal subject:
GASTROENTEROLOGIA
Year:
2015
Document type:
Article
Affiliation country:
Taiwan