Idiopathic Colonic Varices: Case Report and Review of Literature

Abstract

Introduction:Colonic varices represent a very rare entity, either an incidental finding at colonoscopy or discovered due to its complication, the lower gastrointestinal bleeding. The most common cause of colonic varices is portal hypertension associated with liver disease or secondary to pancreatic conditions, like chronic pancreatitis or malignancies. The incidence of colonic varices is very low, even in liver cirrhosis where the patients frequently develop varices in the upper gastrointestinal tract, but surprisingly uncommon present with varices localized in the colon.Case Presentation:We report a case of idiopathic colonic varices, diagnosed at a routine colonoscopy performed for nespecific abdominal disturbances in a female patient without liver disease or pancreatic conditions responsible for portal hypertension development.Conclusions:The development of colonic varices in the absence of a certain trigger represents a major issue for practitioners due to its major complication, lower gastrointestinal bleeding.

Massive Cecal Variceal Hemorrhage Treated with Transjugular Intrahepatic Portosystemic Shunt with Right Colic Vein and Ileocolic Vein Embolization

“…Moreover, cecal varices are usually found in the context of pan-colonic varices, unlike the case described herein [5]. Cecal varices most often develop secondary to portal hypertension, usually in the context of alcohol-induced liver cirrhosis [2]. While alcohol-induced portal hypertension is the most likely cause of cecal varices, various etiologies of portal hypertension as well as more rare factors may give rise to cecal varices.…”

“…Cecal varices are a poorly characterized cause of gastrointestinal bleeding and are rare compared to varices in other locations in the gastrointestinal tract [1]. They usually arise secondary to alcohol-related cirrhosis and may quickly transition from benign to implacable [2]. This case demonstrates a presentation, diagnosis, and treatment of cecal varices and serves to highlight the diagnostic and treatment difficulties for this entity.…”

Idiopathic Pan-Colonic and Small-Intestine Varices

“…Another common cause of portal hypertension and, therefore, colon varices could be thrombosis of the portal vein. Patients with myeloproliferative diseases, antiphospholipid syndrome, protein C and protein S deficiency, antithrombin III deficiency or mutation of factor V Leiden are at a higher risk of portal vein occlusion [1].…”

“…Idiopathic colonic varices represent a rare cause of gastrointestinal bleeding. Management of this condition is individual and can vary greatly according to the clinical presentation and actual condition of the patient [1, 5, 7]. Patients with recurrent massive and haemodynamically unstable haemorrhage require surgery with partial resection of the affected intestinal segment [7].…”

“…Colon varices represent a rare source of severe lower gastrointestinal haemorrhage and have a prevalence rate of around 0.07% [1]. This condition is usually associated with portal hypertension.…”