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Bleeding ectopic varices: clinical presentation, natural history, and outcomes

Kent A Broussard, Don C Rockey
DOI: 10.1136/jim-2021-002021 Published 22 June 2022
Kent A Broussard
1 Department of Internal Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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Don C Rockey
2 Digestive Disease Research Center, Medical University of South Carolina, Charleston, South Carolina, USA
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    Figure 1

    CONSORT diagram. Patients included in the study are shown. CONSORT, Consolidated Standards of Reporting Trials.

  • Figure 2
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    Figure 2

    Actively bleeding varix in the jejunum. Shown is a pooled blood (seen in the left center portion of the image) from a bleeding varix.

Tables

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  • Table 1

    Demographic data

    Location of varicesP value
    Ectopic (n=25)
    Mean (±SD) or n (%)
    Esophageal (n=50)
    Mean (±SD) or n (%)
    Age, mean, years54 (±12)58 (±11)NS
    Gender 
     Male15 (60)31 (62)NS
     Female10 (40)19 (38)NS
    Race 
     African American6 (24)12 (24)NS
     Caucasian19 (76)37 (74)NS
     Hispanic0 (0)1 (2)NS
    • NS, not significant.

  • Table 2

    Laboratory and clinical features

    Location of varicesP value
    Ectopic (n=25)
    Mean (±SD) or n (%)
    Esophageal (n=50)
    Mean (±SD) or n (%)
    Hemoglobin level, mean, g/dL7.47.2NS
    Units of red blood cells, median transfused2.5 (1–37)2 (0–30)NS
    MELD score (patients with cirrhosis only), mean15 (±7)20 (±9)<0.042
    ICU admission (initial admission)11 (44)48 (96)<0.01
    Octreotide administration14 (56)50 (100)<0.01
    Prophylactic antibiotic use13 (52)50 (100)<0.01
    Angiographic evaluation18 (72) 
    Evaluation with EUS6 (24) 
    Small-bowel enteroscopy3 (12) 
    Capsule endoscopy2 (8) 
    • EUS, endoscopic ultrasonography; ICU, intensive care unit; MELD, Model for End-Stage Liver Disease; NS, not significant.

  • Table 3

    Outcomes

    Location of varicesP value
    Ectopic (n=25)
    Mean (±SD) or n (%)
    Esophageal (n=50)
    Mean (±SD) or n (%)
    Clinical outcome 
    Readmission for bleeding11 (44)13 (26)NS
    TIPS (patients with cirrhosis only)14/21 (67)28/50 (56)NS
    Hepatic venous pressure gradient 
     Pre-TIPS (mm Hg)17 (±5)24 (±8)<0.01
     Post-TIPS (mm Hg)6 (±3)8 (±4)NS
    Repeat bleeding after TIPS1 (7)1 (4)NS
    Time to readmission, median (range), days87 (8–515)90 (3–775)NS
    1-year all-cause mortality2 (8)17 (35)<0.05
    • NS, not significant; TIPS, transjugular intrahepatic portosystemic shunt.

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Vol 70 Issue 5 Table of Contents
Journal of Investigative Medicine: 70 (5)
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Bleeding ectopic varices: clinical presentation, natural history, and outcomes
Kent A Broussard, Don C Rockey
Journal of Investigative Medicine Jun 2022, 70 (5) 1280-1284; DOI: 10.1136/jim-2021-002021

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Bleeding ectopic varices: clinical presentation, natural history, and outcomes
Kent A Broussard, Don C Rockey
Journal of Investigative Medicine Jun 2022, 70 (5) 1280-1284; DOI: 10.1136/jim-2021-002021
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Bleeding ectopic varices: clinical presentation, natural history, and outcomes
Kent A Broussard, Don C Rockey
Journal of Investigative Medicine Jun 2022, 70 (5) 1280-1284; DOI: 10.1136/jim-2021-002021
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