An obscure cause of gastrointestinal bleeding: Recurrent duodenal variceal hemorrhage treated with intramuscular octreotide in the absence of portal hypertension

Robert S O'Neill; William J Wang; Patrick Chan; Vincent Ho; Christine Verdon; Ian Turner; Priya Acharya

doi:10.1002/jgh3.12847

An obscure cause of gastrointestinal bleeding: Recurrent duodenal variceal hemorrhage treated with intramuscular octreotide in the absence of portal hypertension

JGH Open. 2022 Dec 12;7(1):78-80. doi: 10.1002/jgh3.12847. eCollection 2023 Jan.

Authors

Robert S O'Neill^{1

2}, William J Wang^{1

3

4}, Patrick Chan¹, Vincent Ho^{1

3}, Christine Verdon^{1

3}, Ian Turner^{1

3}, Priya Acharya^{1

3}

Affiliations

¹ Department of Gastroenterology Campbelltown Hospital Campbelltown New South Wales Australia.
² St Vincent's Clinical School, Faculty of Medicine University of New South Wales Sydney New South Wales Australia.
³ Western Sydney University Campbelltown New South Wales Australia.
⁴ Townsville University Hospital Douglas Queensland Australia.

Abstract

Duodenal varices (DVs) are ectopic gastrointestinal varices (ECVs) associated with portal hypertension (PH). We present the case of an 82-year-old woman who presented with symptomatic anemia secondary to DV hemorrhage diagnosed on oesophagogastroduodenoscopy. This lesion was treated with endoscopic adrenaline injection and clip application. The patient re-presented on multiple occasions with bleeding recurrence localized to the duodenum, which was managed with intramuscular octreotide and oral beta-blockade resulting in sustained remission of bleeding. This case highlights a rare cause of upper gastrointestinal hemorrhage and highlights the value of somatostatin analogues for conservative treatment of DVs.

Keywords: duodenal varices; endoscopy; haemorrhage; radiology; varices.

Publication types

Case Reports