Idiopathic pan-colonic varices

Background: Varices of the lower gastrointestinal tract are known as a sign of portal hypertension or portal vein obstruction. The authors report on the first Hungarian patient with pan-colonic varices without portal hypertension.

Case-report: A 31-year-old male patient was admitted to our department after massive gastrointestinal bleeding requiring transfusion. Varices from rectum to cecum were revealed by colonoscopy. Histological examination of the liver biopsy showed no signs of cirrhosis or fibrosis. Esophago-gastro-duodenoscopy, abdominal ultrasonography and angiography were normal; specifically they did not confirm the suspicion of the portal hypertension or obstruction of superior or inferior mesenteric vein. Endoscopic therapy was not performed, propranolol was started. The massive bleeding has not repeated since the discharge of the patient from hospital.

Conclusion: Based on our experience and a review of medical literature the patients with idiopathic colonic varices have better prognosis than those whose arise secondary to portal hypertension and the conservative medical therapy (beta blocker) seems to be the first choice in such cases.