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Case Reports
A Case of Duodenal Variceal Rupture during Atezolizumab and Bevacizumab Treatment for Hepatocellular Carcinoma.
- Mio Tsuruoka, Jun Inoue, Keishi Ouchi, Kaname Uno, Hideaki Itami, Masashi Ninomiya, Tomoaki Iwata, Akitoshi Sano, Kosuke Sato, Masazumi Onuki, Satoko Sawahashi, Tomoyuki Koike, and Atsushi Masamune.
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan.
- Intern. Med. 2023 May 15; 62 (10): 146714721467-1472.
AbstractDuodenal varices are detected infrequently, and their rupture is very rare. We encountered an 87-year-old man who developed duodenal varices rupture during chemotherapy with atezolizumab and bevacizumab (ATZ/BV) for hepatocellular carcinoma. We identified massive bleeding of a ruptured varix in the horizontal portion of the duodenum with emergency esophagogastroduodenoscopy (EGD). Successful hemostasis was achieved by endoscopic injection sclerotherapy with Histoacryl. Although ATZ/BV can cause esophageal varices rupture, there have been no cases of duodenal varices rupture. We should take care to check the duodenal varices as well as esophagogastric varices before ATZ/BV treatment.
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