A 33-year-old man with a history of venous trunk thrombosis and portal cavernomatosis in 2007 presented chronic liver disease of recent diagnosis of probable alcoholic origin.
Child stage A: No previous admissions due to hepatic failure or bleeding.
The patient came to the emergency room for 4-5 days of evolution of melenic episodes accompanied by abdominal pain and 2-3 episodes of nausea and vomiting.
Urgent endoscopy showed small esophageal varices without red signs.
Large type I esophageal-gastric varices and other varices like type II gastric varices (without connection with esophageal varices, and location other than the fundus), of large size, with stigmatization of active bleeding cclerol %.
Abdominal ultrasound showed data compatible with chronic liver disease with intrahepatic portal vein stenosis and cavernoma, partial thrombosis of the splenic vein, collateral circulation in the splenic hilium, perigastric junction and month.
After a few days, the patient developed a new episode of vomiting associated with dizziness, profuse hypotension and hypotension (70/40 mmHg).
In urgent gastroscopy small esophageal and gastric varices without signs of rupture were observed.
The duodenal bulb showed a large duodenal varice with jet bleeding in erosion of its vertex.
Two cc of cyanoacrylate and 5 cc of 1 % ethoxysclerol are injected, yielding bleeding.
During her stay in the ward she suffered bleeding without another exteriorization and was discharged.
After five months of follow-up the patient has not presented new bleeding episodes.
