+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma



Jejunal Varices Bleeding in a Patient with Extensive Portomesenteric Thrombosis Secondary to Factor V Leiden Mutation: A Management Dilemma



Case Reports in Gastrointestinal Medicine 2019: 4526472



Ectopic varices are portosystemic collaterals that occur away from the gastroesophageal junction and account for 1-5% of all variceal bleeding. Its occurrence in the jejunum is rare. Most common cause of ectopic jejunal varices is portal hypertension especially in those patients who have undergone prior abdominal surgery. Portomesenteric thrombosis is a rare cause of ectopic jejunal varices. Ectopic varices are rare cause of obscure GI bleeding and hence should be always suspected in patients with history of portal hypertension who present with GI bleeding and have negative upper and lower GI endoscopies. Management of patients with ectopic varices is often very challenging and requires multidisciplinary approach. Therapeutic options include endoscopic therapy, interventional radiologic procedures, surgically creating shunting, or surgical resection. We present the case of a 52-year-old patient who was on anticoagulation for extensive portomesenteric thrombosis secondary to factor V Leiden heterozygous mutation and presented with melena and symptomatic anemia. Investigations showed bleeding jejunal varices as the cause of anemia. We discuss the therapeutic options and dilemma in the management of such cases.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 066598973

Download citation: RISBibTeXText

PMID: 30881706

DOI: 10.1155/2019/4526472


Related references

Small bowel varices secondary to chronic superior mesenteric vein thrombosis in a patient with heterozygous Factor V Leiden mutation: a case report. Journal of Medical Case Reports 9: 210, 2015

Extensive arterial thrombosis in a patient with factor V Leiden mutation. Interactive Cardiovascular and Thoracic Surgery 11(1): 127-129, 2010

Jejunal stricture complicating acute mesenteric venous thrombosis secondary to protein C deficiency and factor V Leiden gene mutation. Indian Journal of Gastroenterology 19(2): 79-80, 2000

Extensive life-threatening thrombosis in a patient with heparin-induced thrombocytopenia and factor V Leiden mutation. Haematologica 86(9): 1008, 2001

Extensive jugular and upper limb thrombosis in a patient with factor V Leiden mutation and non-Hodgkin's lymphoma. Australian and new Zealand Journal of Medicine 30(6): 735-736, 2000

Bleeding jejunal varices and portal thrombosis in a splenectomized patient with hereditary spherocytosis. Digestive Diseases and Sciences 45(2): 373-377, 2000

Progressive neurological decline after partial spontaneous thrombosis of a Spetzler-Martin Grade 5 arteriovenous malformation in a patient with Leiden factor V mutation: management and outcome. Journal of Neurosurgery 100(5): 940-945, 2004

Thrombosis in a patient with combined homozygosity for the factor V Leiden mutation and a mutation in the 3'-untranslated region of the prothrombin gene. Blood Coagulation & Fibrinolysis 10(2): 107-110, 1999

Coincidence of factor V Leiden mutation and a mutation in the prothrombin gene at position 20210 in a patient with puerperal cerebral venous thrombosis. Stroke 29(8): 1739-1740, 1998

Coronary thrombosis on patient with the factor V Leiden mutation. Annales Francaises d'Anesthesie et de Reanimation 21(5): 440-444, 2002

Factor V Leiden and extensive upper limb thrombosis in a breast cancer patient receiving tamoxifen. Asia-Pacific Journal of Clinical Oncology 1(2-3): 105-106, 2005

Factor V Leiden mutation presenting as repeated massive GI hemorrhages secondary to venous thrombosis. American Journal of Gastroenterology 92(12): 2310-2311, 1997

Severe thrombosis and pulmonary embolism in a 26-year-old patient with lupus anticoagulants being homozygous for the prothrombin G20210A mutation and heterozygous for the factor V Leiden mutation. Annals of Hematology 80(Suppl. 1): A56, 2001

Factor V Leiden mutation as an additional risk factor of thrombosis in the patient with acute lymphoblastic leukemia. Acta Haematologica Polonica 37(2): 249-254, 2006

Portal and mesenteric vein thrombosis in a patient heterozygous for a mutation (Arg506-->Gln) in the factor V gen (factor V Leiden). Journal of Clinical Gastroenterology 27(4): 361-363, 1998