A person with portal hypertension may develop varices in other sites than around the distal esophagus. Acute bleeding may occur if one or more of these sites rupture.
Sites of varices that can bleed:
(1) duodenum
(2) colon
(3) vagina (in women)
(4) ileostomy
(5) omentum
Bleeding may be spontaneous or triggered by trauma.
Features of bleeding omental varices:
(1) abdominal pain and distension
(2) falling hematocrit with or without hypotension
(3) absence of external hemorrhage
(4) hemoperitoneum
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