Gastrointestinal Haemorrhage Secondary to Ectopic Varices at the Site of Previous Surgery

Abstract

Ectopic varices are uncommon but potentially life-threatening portosystemic venous collaterals. They are high variable and can occur anywhere across the gastrointestinal tract, except for the pathological sites for portoportal or portosystemic varices. Ectopic varices are responsible for 1% to 5% of all gastrointestinal haemorrhage cases, and their bleeding risk is four times that of oesophageal varices. Patients may present acutely with massive upper or lower gastrointestinal bleeding and consequent shock or chronically with anaemia of unknown origin. First-line diagnostic tests include contrast-enhanced computed tomography, gastrointestinal endoscopy, and angiography. Ectopic varices can be an incidental finding on laparotomy and at autopsy. Mortality can be as high as 40% when associated with severe acute haemorrhage. We report three cases of gastrointestinal haemorrhage secondary to ectopic varices at the site of previous surgery.