Diagnosis and management of ectopic varices in portal hypertension.
Tranah, Thomas H Nayagam, Jeremy S Gregory, Stephen Hughes, Sarah Patch, David Tripathi, Dhiraj Shawcross, Debbie L Joshi, Deepak
Tranah, Thomas H
Nayagam, Jeremy S
Gregory, Stephen
Hughes, Sarah
Patch, David
Tripathi, Dhiraj
Shawcross, Debbie L
Joshi, Deepak
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2023-09-09
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Abstract
Ectopic variceal bleeding is a rare cause of gastrointestinal bleeding that can occur in settings of cirrhotic and non-cirrhotic portal hypertension and is characterised by its development at locations remote from the oesophagus and stomach. Ectopic varices can be difficult to identify and access, and, although a relatively uncommon cause of portal hypertensive bleeding, can represent a difficult diagnostic and therapeutic challenge associated with considerable mortality. Low incidence and variance in variceal anatomy preclude large randomised controlled trials, and clinical practice is based on experience from case reports, case series, and specialist centre expertise. Optimisation of survival outcomes relies on understanding a patient's portal venous anatomy and functional hepatic reserve to guide timely and targeted endoscopic and endovascular interventions to facilitate the rapid control of ectopic variceal bleeding.
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Tranah TH, Nayagam JS, Gregory S, Hughes S, Patch D, Tripathi D, Shawcross DL, Joshi D. Diagnosis and management of ectopic varices in portal hypertension. Lancet Gastroenterol Hepatol. 2023 Nov;8(11):1046-1056. doi: 10.1016/S2468-1253(23)00209-1. Epub 2023 Sep 9. PMID: 37683687.
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