Endoscopic Injection Sclerotherapy for Esophageal Variceal Hemorrhage in Myeloproliferative Disorder: Case Report

Overview

Journal J Gastroenterol

Specialty Gastroenterology

Date 1995 Apr 1

PMID 7773355

Citations 1

Authors

M Matsumoto

H Matsumoto

T Miyake

K Nakao

K Iwata

N Yoshida

K Kanai

Affiliations

Soon will be listed here.

Abstract

A 70-year-old woman with myeloproliferative disorder and massive splenomegaly presented with hematemesis. Emergency endoscopy demonstrated bleeding from esophageal varices. Management of variceal hemorrhage by endoscopic injection sclerotherapy, using 5% ethanolamine oleate, was successful. Following the control of variceal bleeding, she was treated with hydroxyurea, a myelosuppressive agent. The spleen size markedly decreased and she was discharged 3 months later. Variceal hemorrhage in myeloproliferative disorder has been reported to be fatal on many occasions, despite different therapeutic approaches, including surgery. In this report, we demonstrated that endoscopic injection sclerotherapy followed by treatment with a myelosuppressive agent was effective in a patient with myeloproliferative disorder and variceal hemorrhage.

Citing Articles

Characteristics of myeloproliferative neoplasm-associated portal hypertension and endoscopic management of variceal bleeding.

Huang X, Zhang M, Ai Y, Jiang S, Xiao M, Wang L Ther Adv Chronic Dis. 2022; 13:20406223221125691.

PMID: 36172080 PMC: 9511301. DOI: 10.1177/20406223221125691.

References

Jacobs P, Maze S, Tayob F . Myelofibrosis, splenomegaly, and portal hypertension. Acta Haematol. 1985; 74(1):45-8. DOI: 10.1159/000206164. View

Oishi N, Swisher S, STORMONT J, Schwartz S . Portal hypertension in myeloid metaplasia. Report of a case without apparent portal obstruction. Arch Surg. 1960; 81:80-6. DOI: 10.1001/archsurg.1960.01300010082015. View

Sarin S, Sachdeva G, Nanda R, Vij J, Anand B . Endoscopic sclerotherapy using absolute alcohol. Gut. 1985; 26(2):120-4. PMC: 1432418. DOI: 10.1136/gut.26.2.120. View

Laszlo J . Myeloproliferative disorders (MPD): myelofibrosis, myelosclerosis, extramedullary hematopoiesis, undifferentiated MPD, and hemorrhagic thrombocythemia. Semin Hematol. 1975; 12(4):409-32. View

SILVERSTEIN M, WOLLAEGER E, BAGGENSTOSS A . Gastrointestinal and abdominal manifestations of agnogenic myeloid metaplasia. Arch Intern Med. 1973; 131(4):532-7. View

Schwartz S . Myeloproliferative disorders. Ann Surg. 1975; 182(4):464-71. PMC: 1344013. DOI: 10.1097/00000658-197510000-00012. View

Terblanche J, Yakoob H, Bornman P, Stiegmann G, BANE R, Jonker M . Acute bleeding varices: a five-year prospective evaluation of tamponade and sclerotherapy. Ann Surg. 1981; 194(4):521-30. PMC: 1345335. DOI: 10.1097/00000658-198110000-00015. View

Dilawari J, Raju G, Chawla Y . Development of large spleno-adreno-renal shunt after endoscopic sclerotherapy. Gastroenterology. 1989; 97(2):421-6. DOI: 10.1016/0016-5085(89)90078-4. View

FITTS Jr W, ERDE A, PESKIN G, Frost J . Surgical implications of polycythemia vera. Ann Surg. 1960; 152:548-58. PMC: 1613680. View

10.

Lukie B, Card R . Portal hypertension complicating myelofibrosis: reversal following splenectomy. Can Med Assoc J. 1977; 117(7):771-2. PMC: 1880077. View

11.

AUFSES Jr A . Bleeding varices associated with hematologic disorders. Arch Surg. 1960; 80:655-9. DOI: 10.1001/archsurg.1960.01290210123025. View

12.

Sullivan A, Rheinlander H, WEINTRAUB L . Esophageal varices in agnogenic myeloid metaplasia: disappearance after splenectomy. A case report. Gastroenterology. 1974; 66(3):429-32. View

13.

Rigby P, Leavell B . Polycythemia vera. A review of fifty cases with emphasis on the risk of surgery. Arch Intern Med. 1960; 106:622-7. DOI: 10.1001/archinte.1960.03820050034007. View

14.

Heaton A, Jacobs P, Dent D, Louw J . Experience with splenectomy in auto-immune thrombocytopenia and agnogenic myeloid metaplasia. S Afr Med J. 1976; 50(39):1506-12. View

15.

PITCOCK J, REINHARD E, JUSTUS B, MENDELSOHN R . A clinical and pathological study of seventy cases of myelofibrosis. Ann Intern Med. 1962; 57:73-84. DOI: 10.7326/0003-4819-57-1-73. View

16.

Takase Y, Ozaki A, Orii K, NAGOSHI K, Okamura T, Iwasaki Y . Injection sclerotherapy of esophageal varices for patients undergoing emergency and elective surgery. Surgery. 1982; 92(3):474-9. View

17.

SIDERYS H, VELLIOS F . PORTAL HYPERTENSION WITHOUT CIRRHOSIS OR EXTRAHEPATIC OBSTRUCTION. REPORT OF A CASE. Am J Surg. 1964; 108:785-9. DOI: 10.1016/0002-9610(64)90032-7. View

18.

Dubois A, Dauzat M, Pignodel C, Pomier-Layrargues G, Marty-Double C, Lopez F . Portal hypertension in lymphoproliferative and myeloproliferative disorders: hemodynamic and histological correlations. Hepatology. 1993; 17(2):246-50. View

19.

DallOglio L, Bagolan P, Ferro F, Ponticelli A, Cadranel S, Rivosecchi M . Endoscopic injection sclerosis of oesophageal varices in children--indications and techniques. Endoscopy. 1984; 16(3):98-100. DOI: 10.1055/s-2007-1018545. View

20.

Blendis L, Banks D, Ramboer C, Williams R . Spleen blood flow and splanchnic haemodynamics in blood dyscrasia and other splenomegalies. Clin Sci. 1970; 38(1):73-84. DOI: 10.1042/cs0380073. View