A case of sarcoidosis liver caused rupture of esophageal varices due to sudden portal hypertension

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  • Morosawa Tatsuki
    Division of Gastroenterology, Tohoku University School of Medicine
  • Kondo Yasuteru
    Division of Gastroenterology, Tohoku University School of Medicine
  • Kimura Osamu
    Division of Gastroenterology, Tohoku University School of Medicine
  • Iwata Tomoaki
    Division of Gastroenterology, Tohoku University School of Medicine
  • Ninomiya Masashi
    Division of Gastroenterology, Tohoku University School of Medicine
  • Kakazu Eiji
    Division of Gastroenterology, Tohoku University School of Medicine
  • Kogure Takayuki
    Division of Gastroenterology, Tohoku University School of Medicine
  • Iwasaki Takao
    Division of Gastroenterology, Tohoku University School of Medicine
  • Shimosegawa Tooru
    Division of Gastroenterology, Tohoku University School of Medicine

Bibliographic Information

Other Title
  • 急激に門脈圧亢進症をきたし，食道静脈瘤破裂で発症した肝サルコイドーシスの1例
  • 症例報告 急激に門脈圧亢進症をきたし,食道静脈瘤破裂で発症した肝サルコイドーシスの1例
  • ショウレイ ホウコク キュウゲキ ニ モンミャクアツ コウシンショウ オ キタシ,ショクドウ ジョウミャクリュウ ハレツ デ ハッショウ シタ カン サルコイドーシス ノ 1レイ

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Abstract

A 44-year-old female patient, visited a near-by ophthalmologist with a chief complaint of photophobia in 2011 and was diagnosed with uveitis. She was referred to our department of respiratory medicine for further evaluation and was diagnosed with pulmonary sarcoidosis. However, since no respiratory disturbances were observed, the patient was kept on for follow-up observation. In March 2012, emergency endoscopy was conducted due to melena and hematemesis, and a diagnosis of rupture of esophageal varices. Subsequently, endoscopic variceal sclerotherapy was conducted. The endoscopy performed five months prior to the event did not show varices. The observation from the abdominal CT and MRI was consistent with that of hepatic sarcoidosis. A laparoscopic liver biopsy was taken and the diagnosis was confirmed histologically as hepatic sarcoidosis. We assumed that the sudden progression of hepatic sarcoidosis led to portal hypertension and this has caused the rapid formation and rupture of hepatic sarcoidosis. Oral steroid was administered for prevention because the findings from the pathological tissue indicated a risk of developing cirrhosis. Five months later have blood biochemical test results showed improvement.<br>

Journal

  • Kanzo

    Kanzo 54 (5), 354-362, 2013

    The Japan Society of Hepatology

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