The clinical characteristics, endoscopic treatment, and prognosis for patients presenting with duodenal varices.

BACKGROUND/AIMS: This study investigated the clinical characteristics, endoscopic appearances, usefulness of endoscopic treatments, and survival of patients with duodenal varices.

METHODOLOGY: Twelve patients were evaluated in whom endoscopy confirmed duodenal varices (13 lesions), and patient data was retrospectively analyzed regarding underlying diseases, hepatic function, endoscopic appearance, previous treatment for other complicated varices, endoscopic treatment for hemorrhage from duodenal varices, and survival.

RESULTS

Underlying diseases consisted of liver cirrhosis in 8 patients, and pancreatic cancer-related pylemphraxis in 4 patients. Endoscopic appearances of hemorrhage from duodenal varices revealed negative red color (RC) signs in all 6 lesions, and 5 of 6 lesions were F3 lesions. Three of 5 patients with hemorrhagic duodenal varices had received treatment for esophageal varices. Successful hemostasis and complete eradication by endoscopic treatments was achieved in all 5 patients (6 lesions). The 1, 3, and 5 year cumulative survival rates were 66.7%, 48.6%, and 36.5% in the patients with duodenal varices.

CONCLUSIONS

The hemorrhagic factor of duodenal varices is F factor, but not RC sign. Changes of blood flow in the collateral circulatory pathway after treatment for esophageal varices may increase the risk of hemorrhage from duodenal varices. Endoscopic treatment is useful for hemorrhagic duodenal varices.