Colonic varices as a complication of colonic surgery

Arbona, J. L.; Lichtenstein, Joel E.; Spies, JB; Hyatt, John R.

doi:10.1007/bf01885180

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…RV arises from PH of liver cirrhosis in about 70% of patients [30]. Other causes of RV include postoperative intraperitoneal adhesion, mesentefic vein obstruction, congenital anomalies of the portal system, vascular deformation, and heart failure [30][31][32][33][34]. It is easy to visualize dilated, swollen vessels of the colon under endoscopic control as in the esophagus, but the incidence of RV in PH is about 20% in Japan [1,12,13].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Rectal Varices by Endoscopic Ultrasonography in Patients With Portal Hypertension

Kobayashi

2001

Diagnostic and Therapeutic Endoscopy

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The usefulness of endoscopic ultrasonography (EUS) in the evaluation of rectal varices (RV) was determined in 50 patients with portal hypertension (PH) and 25 PH-free controls. F1 and F2 varices and angiectasia were specific for the PH group as evaluated by endoscopy, but there was no difference between the PH and the control groups with respect to the frequency of blue vein. The detection rate of submucosal veins (SMV) with EUS was 88% for the PH group and 68% for the control group. The mean SMV diameter was significantly greater for the PH group than for the control group, and no 2-mm or larger SMV was detected in the control group. Serum albumin and cholinesterase levels were significantly higher for the RV(+) patients with SMV 2mm or more in diameter in the PH group than for the RV(–) patients. The spleen index was also significantly higher for the former group. The frequency of RV was significantly higher for advanced PH than for mild PH. RV(+) was detected in about 30% of endoscopically normal patients in the PH group. The results of this study indicate that EUS is useful in detecting RV and evaluating its pathological condition.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Rectal Varices by Endoscopic Ultrasonography in Patients With Portal Hypertension

Kobayashi

2001

Diagnostic and Therapeutic Endoscopy

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“…Rarely, other conditions, such as bowel resection and adhesion-related operations [24, 25, 26], congenital vascular anomalies [27], and idiopathic vasculopathy [28, 29, 30, 31]are implicated. Although portal hypertension is quite common, colonic varices are rarely found.…”

Section: Discussionmentioning

confidence: 99%

Massive Gastrointestinal Bleeding from Colonic Varices in a Patient with Portal Hypertension

Naef¹,

Holzinger²,

Glättli³

et al. 1998

Dig Surg

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Colonic variceal bleeding is a rarity and is most commonly due to portal hypertension. The present report describes a patient with portal hypertension due to portal vein thrombosis who, following esophageal transection and successful sclerotherapy, developed a massive lower gastrointestinal bleeding from colonic varices. The literature is reviewed, and the pathophysiology of this complication is discussed. Possible etiologies of this condition may be esophageal transection and devascularization, successful sclerotherapy, and extensive thrombosis of the portal vein resulting in obliteration of the coronary-azygous anastomotic system. In such a situation other potential sites of portosystemic anastomoses, such as the colon, may be opened up, resulting in the development of colonic varices. Indeed, the incidence of colonic varices in two series after sclerotherapy for esophageal varices was 60–100%. Of 33 candidates evaluated for liver transplantation, colonic varices were found in 1.

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Les aspects endoscopiques de l’hypertension portale: diagnostic et classification

et al. 2000

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Endoscopic diagnosis and classification of varices of the gastro-intestinal tract RI~SUMI~Quand s'instaure un Otat d'hypertension portale, des circulations collatOrales entre le syst~me porte et le systOme cave se forment ou s'ouvrent.Du point de vue clinique, les plus importantes sont celles qui impliquent le secteur gastro-intestinal, parce qu'elles peuvent provoquer la dilatation du plexus sous-muqueux avec formation de varices endoluminales.Les varices peuvent se trouver sur tousles secteurs du tractus gastro-intestinal (~esophage, estomac, duod6num, il6on, c61on, rectum), mais les varices gastro-oesophagiennes s'observent plus fr6quemment et en cas de rupture, elles peuvent provoquer de graves h6morragies. L'h6morragie de varices oesophagiennes repr6sente encore aujourd'hui une des plus graves complications de la cirrhose h6patique et un d6fi toujours renouvel6 pour l'endoscopiste.Malgr6 l'introduction de nouveaux moyens diagnostiques et de nouvelles th6rapies, la mortalit6 au premier 6pisode de saignement reste encore tr~s 61ev6e (30 %-40 %).Ceci est 1i6 non seulement h l'entit6 de l'h6morragie et ~ la vitesse de son contr61e mais 6galement au stade d'insuffisance h6patique et h l'apparition de complications cardio-pulmonaires, r6nales, infectieuses et surtout h6morragiques.L'examen endoscopique, s'il est conduit de mani6re correcte, repr6sente la meilleure technique pour le diagnostic, la classification et la th6rapie aussi bien en premi6re intention qu'en urgence. SUMMARY During portal hypertension occurs the formation and~or opening of collateral circulations between the portal and caval systems. One of the most significant clinical consequences is the formation of endoluminal varices at the intestinal level There is also congestion of the mucosa, termed portal congestive gastropathy or portal congestive colonopathy, depending on the area affected.Varices could be present in the entire gastro-intestinal tract (esophagus, stomach, duodenum, ileum, colon, rectum). However the most frequently observed are the esophageal varices and in case of rupture they cause severe haemorrhage. Bleeding from esophageal varices is one of the most important complications of liver cirrhosis and represents a critical moment for the endoscopist. Although the use of modern diagnostic and therapeutic technique, mortality during the first episode of bleeding still remains very high (30-40%).This is related not only to the entity of the haemorrhagic fact and the endoscopic ability to control it, but also to the degree of the liver disease, cardiopulmonary, kidney, infective and haemorrhagic complications.Endoscopic examination, if correctly performed, represents the best technique for the diagnosis, the classification and the therapeutic approach both in election and emergency.

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Colonic varices as a complication of colonic surgery

Cited by 6 publications

References 7 publications

Evaluation of Rectal Varices by Endoscopic Ultrasonography in Patients With Portal Hypertension

Evaluation of Rectal Varices by Endoscopic Ultrasonography in Patients With Portal Hypertension

Massive Gastrointestinal Bleeding from Colonic Varices in a Patient with Portal Hypertension

Les aspects endoscopiques de l’hypertension portale: diagnostic et classification

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