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KMID : 0882420080750020215
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Korean Journal of Medicine
2008 Volume.75 No. 2 p.215 ~ p.220
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A case of variceal bleeding of the ascending colon associated with alcoholic liver cirrhosis
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Kim Heung-Up
Her Kyu-Hee
Kim Seong-Hyung
Kim Bong-Soo
Kang Young-Joon
Lee Jae-Chun
Kim Kwang-Sig
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Abstract
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We report a very rare case of colonic varix with massive bleeding. A 43-year-old male patient was transferred to our
hospital for hematochezia. The patient had a history of chronic liver disease associated with alcohol use. The initial blood
pressure was 93/73 mmHg, and the hemoglobin level was 8.4 g/dL. Severe hepatomegaly and periportal fatty infiltration
were seen on abdominal computed tomography. Markedly ectatic veins protruded from the luminal side of the proximal
ascending colon and drained to the dilated ileocecal and retroperitoneal veins. Emergent colonoscopy failed because of
continuous hematochezia and hypovolemic shock, despite massive transfusion. Markedly dilated colonic varices were
noticed around the ileocecal and ascending colon on superior mesenteric arteriography. An emergent right hemicolectomy
was performed. The presumed bleeding focus was a protruding varix with a red clot on the top of a denuded vein on the
anteromedial wall of the proximal ascending colon. (Korean J Med 75:215-220, 2008)
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KEYWORD
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Colonic varices, Gastrointestinal hemorrhage, Liver cirrhosis, Alcoholic
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