PMC9072047_01
CT angiography showing a varix in the sac of the umbilical hernia.
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CT angiography and red blood cell nuclear scan were unable to identify any leak into the gastrointestinal system but described variceal vessels in the sac of the umbilical hernia and perigastric and perisplenic area (shown in Figures 1 and 2).
Red blood cell nuclear scan showing variceal vessels in the area of the hernia.
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CT angiography and red blood cell nuclear scan were unable to identify any leak into the gastrointestinal system but described variceal vessels in the sac of the umbilical hernia and perigastric and perisplenic area (shown in Figures 1 and 2).
The ileum with the identified varix.
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The patient's state progressed, and as all endoscopic and imaging methods were unsuccessful, we carried out an explorative laparotomy to find a 5 mm thick varix in the ileum without active bleeding during the time of surgery (Figure 3).
Enteroscopy showing the nipple sign at the site of the varix.
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We confirmed the varix as the culprit lesion by peroperative enteroscopy showing typical signs of recent bleeding (Figure 4).
The resected part of the ileum.
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A resection of the affected part of the ileum was performed without significant early complications (Figure 5).
Histological examination of the resected part of the ileum.
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The histological examination found erosions of the mucous membrane with edema and variceal vessels in the submucosal and subserosal layers (Figure 6).