Summary
Massive bleeding from jejunal varices in a young alcoholic with cirrhosis and portal hypertension ceased following a portocaval shunt. Although rare, bleeding from small or large bowel varices has a high mortality. In 62 cases, small or large bowel varices are almost always associated with a predisposing condition including previous abdominal surgery and portal hypertension from cirrhosis or other causes. Hematochezia without hematemesis and nonbleeding esophageal varices generally occur. Angiography is the best diagnostic test.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Feldman M, Smith VM, Warner CG: Varices of the colon: Report of three cases. JAMA 179:729–730, 1962
Bruet A, Fingerhut A, Lopez Y, Bergue A, Taugourdeau P, Mathe C, Hillion D, Fendler JP: Ileal varices revealed by recurrent hematuria in a patient with portal hypertension and Mekong schistosomiasis. Am J Gastroenterol 78:346–350, 1983
Cello JP, Crass RA, Federle MP: Colonic varices: An unusual source of lower gastrointestinal hemorrhage. West J Med 136:252–255, 1982
Izsak EM, Finlay JM: Colonic varices. Am J Gastroenterol 73:131–136, 1980
Berezin S, Yu WY, Filippo AS, Newman LJ: Colonic variceal bleeding in a child. J Pediatr Surg 20:88–89, 1985
Katz LB, Shakeed A, Messer J: Colonic variceal hemorrhage: Diagnosis and management. J Clin Gastroenterol 7:67–69, 1985
Manzi D, Samanta AK: Adhesion-related colonic varices. J Clin Gastroenterol 7:71–75, 1985
Soper NJ, Rikkers LF, Miller FJ: Gastrointestinal hemorrhage associated with chronic mesenteric venous occlusion. Gastroenterology 88:1964–1967, 1985
Vescia FG, Babb RR: Colonic varices: A rare, but important cause of gastrointestinal hemorrhage. J Clin Gastroenterol 7:63–65, 1985
Wang MM, McGrew W, Dunn GD: Variceal bleeding from an ileostomy stoma. South Med J 78:733–737, 1985
Foutch PG, Sivak MV: Colonic variceal hemorrhage after endoscopic injection sclerosis of esophageal varices: A report of three cases. Am J Gastroenterol 79:756–760, 1984
Ostrow B, Blanchard RJW: Bleeding small-bowel varices. Can J Surg 27:88–89, 1984
Goldstein MB, Brandt LJ, Bernstein LH, Sprayragen S: Hemorrhage from ileal varices: A delayed complication after total proctocolectomy in a patient with ulcerative colitis and cirrhosis. Am J Gastroenterol 78:351–354, 1983
Grundfest-Broniatowski S, Fazio V: Conservative treatment of bleeding stomal varices. Arch Surg 118:981–985, 1983
Lieberman DA, Krippaehne WW, Melnyk CS: Colonic varices due to intestinal cavernous hemangiomas. Dig Dis Sci 28:852–858, 1983
Van der Jagt EJ: Varices of the colon. Diagn Imaging 52:230–235, 1983
Falchuk KR, Aiello MR, Trey C, Costello P: Recurrent gastrointestinal bleeding from ileal varices associated with intraabdominal adhesions: Case report and review of the literature. Am J Gastroenterol 77:859–860, 1982
Agarwal D, Scholz FJ: Small bowel varices demonstrated by enteroclysis. Radiology 140:350, 1981
Cooper MJ, Mackie CR, Dhorajiwala J, Baker AL, Moosa AR: Hemorrhage from ileal varices after total proctocolectomy. Am J Surg 141:178–179, 1981
Eckhauser FE, Sonda LP, Strodel WE, Edgcomb LP, Turcotte JG: Parastomal ileal conduit hemorrhage and portal hypertension. Ann Surg 192:620–624, 1980
Mills PR, Behan WMH, Watkinson G: haemorrhage from colonic varices associated with portal hypertension. Br J Clin Pract 34:347–351, 1980
Pickens CA, Tedesco FJ: Colonic varices: Unusual cause of rectal bleeding. Am J Gastroenterol 73:73–74, 1980
Ricci RL, Lee KR, Greenberger NJ: Chronic gastrointestinal bleeding from ileal varices after total proctocolectomy for ulcerative colitis: Correction by mesocaval shunt. Gastroenterology 78:1053–1058, 1980
Park RW, Watkins JB: Mesenteric vascular occlusion and varices complicating midgut malrotation. Gastroenterology 77:565–568, 1979
Patel KR, Wu TK, Powers SR: Varices of the colon as a cause of gastrointestinal hemorrhage: Report of a case and review of the literature. Dis Colon Rectum 22:321–323, 1979
Wilson SE, Stone RT, Christie JP, Passaro E: Massive lower gastrointestinal bleeding from intestinal varices. Arch Surg 114:1158–1161, 1979
Moncure AC, Waltman AC, Vandersalm TJ, Linton RR, Levine FH, Abbott WM: Gastrointestinal hemorrhage from adhesion-related mesenteric varices. Ann Surg 183:24–29, 1976
Hamlyn AN, Lunzer MR, Morris JS, Puritz H, Dick R: Portal hypertension with varices in unusual sites. Lancet 2:1531–1534, 1974
Doberneck RC, Janovski NA: Isolated bleeding from colonic varices in patients with liver disease. Dig Dis Sci 15:834–841, 1970
Castleman B, Towne VW: Case records of the Massachusetts General Hospital: Case 40102-varices of sigmoidal veins. N Engl J Med 250:434–438, 1954
Graham DY, Smith JL: The course of patients after variceal hemorrhage. Gastroenterology 80:800–809, 1981
Garceau AJ, Chalmers TC: The natural history of cirrhosis I: Survival with esophageal varices. N Engl J Med 268:469–473, 1963
Edwards EA: Functional anatomy of portosystemic communications. Arch Intern Med 88:137–154, 1951
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cappell, M.S., Price, J.B. Characterization of the syndrome of small and large intestinal variceal bleeding. Digest Dis Sci 32, 422–427 (1987). https://doi.org/10.1007/BF01296297
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01296297