Comment prévenir et traiter les hémorragies par varices gastriques, ou ectopiques ou par gastropathie congestive

[Embolization of recurrent bleeding jejunal varices]

We report a case of recurrent digestive haemorrhage due to bleeding ectopic jejunal varices complicating portal hypertension in a 51-year-old cirrhotic patient, treated 1 year ago by transjugular intrahepatic porto-systemic shunt (TIPS) for the same problem. Successful embolisation with coils, of ectopic varices, was performed using original transjugular and trans-TIPS route, without complication, and no recurrence during a follow-up of 24 months.

[Bleeding from rectal varices in a patient with severe decompensated cirrhosis: success of endoscopic band ligation. A case report and review of the literature]

In patients with cirrhosis, portal hypertension can be complicated by bleeding rectal varices. Treatment of bleeding rectal varices is not well established because clinical therapeutic trials are scarce in the literature and there are only a few case reports. In most cases, first line treatment is endoscopic (band ligation or sclerotherapy) and in case of failure or rebleeding, portosystemic shunts are the second line treatment. The indication of endoscopic treatment is not always easy in patients with cirrhosis and impaired liver function as well as major haemostatic problems. We report the case of a patient with severe decompensated cirrhosis and bleeding rectal varices who was successfully treated by endoscopic band ligation.