Idiopathic Pan-Colonic and Small-Intestine Varices

Abstract

Idiopathic colonic varices represent a rare source of gastrointestinal haemorrhage with a presumed incidence around 0.0007%. Herein, we present a case of idiopathic colonic and small-intestine varices. According to our knowledge, this case report is the first description of both pan-colonic and small-intestine idiopathic varices of this extent. A young male patient without any previous notable medical history was admitted to the hospital because of massive enterorrhagia with haemodynamic instability. Colonoscopy revealed massive pan-colonic varices. After stabilization, numerous diagnostic procedures were performed in order to investigate the aetiology of pan-colonic varices without any explanation of the patient’s condition. In addition, capsule endoscopy revealed varices through the whole length of the small intestine. The final diagnosis was idiopathic varices of the colon and small intestine. Because of the rapid clinical stabilization, the single incident of haemorrhage and the extension of the disease, a conservative approach was chosen (venotonics and β-blockers). During the 12-month follow-up period, the patient reported no gastrointestinal haemorrhage.

Massive hematochezia due to jejunal varices successfully treated with coil embolization

“…In fact, familial idiopathic small intestine varices have been reported previously 7 . To the best of our knowledge, only three cases have been described 7–9 . It is worth noting however that the case reports of idiopathic colic varices seem to be more common 9 …”

“…7 To the best of our knowledge, only three cases have been described. [7][8][9] It is worth noting however that the case reports of idiopathic colic varices seem to be more common. 9 Small bowel varices are reported to bleed in 25% of cases.…”

“…[7][8][9] It is worth noting however that the case reports of idiopathic colic varices seem to be more common. 9 Small bowel varices are reported to bleed in 25% of cases. 10 The clinical presentation of small bowel varices is typically characterized by a triad: history of abdominal surgery, PHT and hematochezia without hematemesis.…”

Lower Gastrointestinal Bleeding Associated With Variceal Hemorrhoidal Disease in a Patient With Pan-Colonic Varices

“…Colonic varices are a rare condition with a general prevalence of around 0.07%, as reported by Feldman et al in a study that autopsied 2,912 patients with gastrointestinal bleeding [3]. In most cases, they occur as a consequence of portal hypertension, primarily due to cirrhosis, hepatocellular carcinoma, or portal thrombosis [1][2][3][4][5][6]. However, fewer than 50 cases have been reported with an idiopathic presentation of pancolonic involvement [1,2], with even lower prevalence rates.…”

“…In most cases, they occur as a consequence of portal hypertension, primarily due to cirrhosis, hepatocellular carcinoma, or portal thrombosis [1][2][3][4][5][6]. However, fewer than 50 cases have been reported with an idiopathic presentation of pancolonic involvement [1,2], with even lower prevalence rates. Males are more commonly affected, with a ratio of 25:15, and the average age of presentation is 41 years, ranging from 14 to 81 years [5,7].…”