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Báo cáo y học: " Acute variceal bleeding in a patient with idiopathic myelofibrosis successfully treated with endoscopic variceal band ligation and chemotherapy: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Acute variceal bleeding in a patient with idiopathic myelofibrosis successfully treated with endoscopic variceal band ligation and chemotherapy: a case report | Tamaki et al. Journal of Medical Case Reports 2010 4 25 http www.jmedicalcasereports.eom content 4 1 25 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Acute variceal bleeding in a patient with idiopathic myelofibrosis successfully treated with endoscopic variceal band ligation and chemotherapy a case report Kumiko Tamaki Michiro Otaka Naoto Sakamoto Kenshi Matsumoto Shunhei Yamashina Sumio Watanabe Abstract Introduction Idiopathic myelofibrosis is a chronic myeloproliferative disorder characterized by leukoerythroblastosis massive splenomegaly and increases in the reticular and collagen fibers in the bone marrow. Portal hypertension is observed in some patients with idiopathic myelofibrosis. Gastrointestinal hemorrhages which are due mostly to the rupture of the esophageal varices have been sporadically reported to be an infrequent complication of idiopathic myelofibrosis. Case presentation We report a case of a Japanese 63-year-old woman with myelofibrosis and variceal hemorrhage with a background of concomitant portal and pulmonary hypertension. She was successfully treated through a combination of endoscopic variceal ligation and chemotherapy. Conclusion This is the first known report on the successful application of endoscopic variceal ligation and chemotherapy as the therapeutic procedure for an esophageal variceal hemorrhage in a patient with myelofibrosis. Introduction Myelofibrosis one of the chronic myeloproliferative disorders is characterized by a massive splenomegaly leukoerythroblastosis and increased reticular and collagen fibers in the bone marrow 1 2 . Portal hypertension has been observed in 10 to 17 of patients with idiopathic myelofibrosis IMF 1 2 . A gastrointestinal hemorrhage which is due mostly to the rupture of the esophageal varices has been sporadically reported to be an infrequent complication of IMF 3-6 . However the management of variceal bleeding can be complicated as esophageal varices could be caused by portal .