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Duodenal varix as a presentation of hepatocellular carcinoma
Duodenal varix as a presentation of hepatocellular carcinoma
André Coimbra Trigo, Mafalda João, Sandra Lopes, Pedro Figueiredo
Centro Hospitalar da Universidade de Coimbra
A 79-year-old man with alcoholic liver cirrhosis presented with hematemesis. An upper endoscopy revealed a varix at the anterior wall of bulb with a red wale sign, indicating recent bleeding. An injection N-butyl-2 cyanoacrylate plus metacryloxisulfolane was successfully performed. The abdominal computed tomography angiography scan revealed a 29x26-mm nodule consistent with hepatocellular carcinoma (HCC), tumoral portal vein thrombosis and communicating collateral from the superior mesenteric vein feeding the duodenal varix with no splenorenal shunt.
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