[Upper gastrointestinal hemorrhage due to vena cava obstruction].

Abstract

Occlusive disease of the inferior vena cava is rare. The experiences of diagnosis and uncommon complications of bleeding in a case of a now 21-year-old male are reported. Real-time ultrasound examination and cavography are very useful for diagnosis and planing of surgical intervention. Causes of complete occlusion of the VCI in early childhood are malignant tumours or an abdominal mass. Usually cava-azygos collaterals may enlarge sufficiently. Normally, vertebral pathways with sufficient circulation prevent oedema of the limbs, bilateral varicoceles and caput medusae of the abdominal wall. The vasa vasorum or intrahepatic pathways rarely contribute to the collateral circulation. In the present case, varicosities of the duodenum caused intestinal bleeding. Neither treatment by resection nor a shunt procedure may promise definite relief if collateral veins are bleeding diffusely. Stenosis and occlusion of VCI and small shot-like ulcers above the varicosities of the duodenum were the major observations found in the case under discussion.