Sigmoid Ectopic Varix Complicating Primitive Biliary Cholongitis Treated by Sclerotherapy

Abstract

Ectopic varices correspond to the development of collateral circulation outside the oeso-cardio-fundic region. Ectopic rectal varices are the most frequently reported ectopic varices probably because of their ease of diagnosis (4% to 89% of patients with portal hypertension). Their rupture is rare but can be severe.We report the case of a 51-year-old female patient with primary biliary cholangitis at the stage of cirrhosis. Admitted in our department for intermittent rectal bleeding with deep asthenia, starting 3 months before. A biological test has revealed a hypochromic microcytic anemia. Esophago-gastroduodenoscopy showed the presence of stage II oesophageal varices without red signs associated with portal hypertension gastropathy. A colonoscopy showed an ectopic varix at the sigmoid and the rest of the colonic mucosa was normal. The management of these varices consisted on the ligation of the esophageal ones, while for the ectopic sigmoid varix; a sclerotherapy was performed, by diluting 3cc of Aetoxisclerol with 8cc of 9% saline serum. The procedure was uneventful with absence of rectal bleeding up to 24months of follow-up.