A Case of Idiopathic Colonic Varices

Abstract

Colonic varices, usually detected by means of colonoscopy, are extremely rare and typically indicative of portal hypertension or chronic hepatopathology. Even more rare are those cases with no underlying disease, or idiopathic colonic varices. The authors report a case of these unexplained varices found during colonoscopy of a 30-year-old man with a 10-year history of diarrhea and occasional bloody stool. A thorough workup was performed, revealing no underlying abnormalities for his varices. Additionally, the authors review the literature of this rare diagnosis. Physicians must rule out hepatic, vascular, and cardiac causes before classifying a case of varices as idiopathic.

Idiopathic Isolated Colonic Varices: An Extremely Rare Condition

“…Patients with colonic varices typically present with hematochezia or blood in the rectum, which may or may not be accompanied by pain. Idiopathic colonic varices, which cannot be explained by an underlying pathology, may also cause recurrent episodes of lower gastrointestinal bleeding [ 3 ]. It is not unusual for patients to first present with a massive gastrointestinal bleed, which is why practitioners must recognize the potential for varices within the colon, even in the absence of portal hypertension or varices elsewhere [ 4 ].…”

“…Idiopathic colonic varices exhibit a much stronger familial association compared to non-idiopathic colonic varices and are more likely to be pan-colonic. A case report from 2013 found evidence of only 38 total documented instances of idiopathic colonic varices in the literature [ 3 ]. Aside from being identified as either idiopathic or non-idiopathic, colonic varices can also be described as isolated if they are identified in the absence of esophageal or other ectopic varices.…”

Idiopathic Isolated Colonic Varices: An Extremely Rare Condition

“…Patients with colonic varices typically present with hematochezia or blood in the rectum, which may or may not be accompanied by pain. Idiopathic colonic varices, which cannot be explained by an underlying pathology, may also cause recurrent episodes of [3]. It is not unusual for patients to first present with a massive gastrointestinal bleed, which is why practitioners must recognize the potential for varices within the colon, even in the absence of portal hypertension or varices elsewhere [4].…”

Idiopathic Colonic Varices: A Rare Cause of Recurrent Lower Gastrointestinal Bleeding

“…Instances of vascular malformation and a familial component have been described in the literature. 2 Currently, no guidelines exist for monitoring colonic varices or screening for varices in family members. There is no known association with development of malignancy reported in the literature.…”