A 54-year-old male, hypertensive, type II diabetic with alcoholic liver cirrhosis, Child stage C, with portal hypertension.
He had grade II esophageal varices and had not required admission for gastrointestinal bleeding.
She came to the emergency department with recurrent vomiting and rectal bleeding.
Urgent gastroscopy showed three small-sized varicose cords with red signs on the wall affecting the lower third of the esophagus, with no evidence of active bleeding at the time of examination.
Two ligation bands were placed.
Abdominal ultrasound revealed signs of chronic liver disease with signs of portal hypertension, hepatofugal portal flow and ascites.
There was no evidence of active bleeding or potentially bleeding lesions in the stomach or duodenum.
Subsequently, the patient presented a new episode of melenic stools. An endoscopy showed three small varicose cords with two septa in the distal third and some edema.
In the stomach red blood in greater curvature.
Duodenum presented duodenal varice in second portion with fibrin nipple.
1 cc of cyanoacrylate and 4 cc of ethoxysclerol were injected.
After endoscopic treatment she did not present new episodes of exteriorization of bleeding or anemization so she was discharged.
After 13 months of follow-up, the patient has not presented new admissions for upper gastrointestinal bleeding secondary to bleeding due to duodenal varices.
