A 48-Year-Old With Cirrhosis and Sudden Abdominal Distension

Jennifer L. Martindale, MD; Jonathan Elmer, MD; Joshua M. Kosowsky, MD


April 05, 2023

In this case, the patient's postprocedural course was characterized initially by worsening liver failure, elevated intra-abdominal pressures, and confusion. He eventually progressed to frank encephalopathy, hepatorenal syndrome, and pneumonia. Ultimately, the decision was made by the family to employ only comfort measures, and the patient expired 12 days after presentation.

Although rare, the diagnosis of a bleeding ectopic varix is important to consider because it requires aggressive resuscitation and rapid intervention. However, even with rapid diagnosis and therapy, the mortality associated with ectopic variceal rupture remains exceedingly high, as evidenced by this patient.


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