Upper gastrointestinal bleeding with duodenal varix: A case report

Table 1 Laboratory findings during hospitalization

Parameter	Reference range	Initial presentation (hospital day 1)	Recurrent bleeding (hospital day 20)
Complete blood count
Hemoglobin (g/dL)	13.0-17.0	6.1	7.6
Hematocrit (%)	39-52	20.6	22.8
White blood cells (× 109/L)	4.0-10.0	4.9	4.3
Platelets (× 109/L)	150-400	275	243
Renal function
Blood urea nitrogen (mg/dL)	8-23	23.6	10.4
Creatinine (mg/dL)	0.6-1.2	0.96	0.74
Estimated GFR (mL/minute/1.73 m2)	> 60	93	106
Electrolytes
Sodium (mmol/L)	135-145	138	140
Potassium (mmol/L)	3.5-5.1	4.4	4.0
Chloride (mmol/L)	98-107	105	107
Liver function tests
Aspartate aminotransferase (U/L)	0-40	19	22
Alanine aminotransferase (U/L)	0-40	11	25
Alkaline phosphatase (U/L)	40-129	117	118
Total bilirubin (mg/dL)	0.2-1.2	0.39	0.51
Albumin (g/dL)	3.5-5.0	3.6	2.9
Coagulation profile
Prothrombin time (second)	11-14	12.1	12.6
INR	0.8-1.2	1.1	1.2

INR: International normalized ratio.

Table 2 Selected reports on management of ectopic varices

Ref.	Varix site	Modality	Intervention	Outcome
Kim et al[22], 2020	Duodenum	Interventional radiology	Percutaneous trans-splenic variceal obliteration	Alternative option for balloon-occluded retrograde transvenous obliteration
Lee et al[5], 2023	Duodenum	Interventional radiology	PARTO	Successful PARTO for an isolated duodenal varix
Hau et al[24], 2014	Duodenum	Surgery	Collateral caval shunt	Surgical shunt controlled bleeding in non-cirrhotic portal hypertension
Solanki et al[23], 2021	Jejunum	Surgery	Segmental bowel resection	Effective hemostasis on localized, refractory ectopic varices

PARTO: Plug-assisted retrograde transvenous obliteration.