From the Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China.
Ann Saudi Med. 2020 May-Jun;40(3):255-258. doi: 10.5144/0256-4947.2020.255. Epub 2020 Jun 4.
Colonic varices are lesser-known in comparison with gastroesophageal varices in a complication associated with liver cirrhosis. The ideal therapeutic intervention for a colonic varix is still unclear. We report a 42 year-old man with 20 years of alcohol use who presented with hematochezia and abdominal distension. The patient was diagnosed with alcoholic liver cirrhosis. The colonoscopy revealed a dilated and tortuous varix in the transverse colon close to the hepatic flexure with oozing blood, a communicating branch and with "red sign", evidence of acute bleeding. Endoscopic band ligation (EBL), the most useful intervention for esophageal varices, was further successfully performed to arrest the bleeding colonic varices. One month after initial treatment, the colonic varices nearly vanished and were replaced by an ulcer. It is extremely rare for colonic varices to be treated with EBL. There is only one similar case in reported literature, but it seems to be safe and effective as an intervention for EBL for acute colonic variceal bleeding. SIMILAR CASES: Second case treated by endoscopic band ligation.
结肠静脉曲张相比与肝硬化相关的胃食管静脉曲张，较为鲜为人知。结肠静脉曲张的理想治疗干预措施仍不明确。我们报告了 1 例有 20 年饮酒史的 42 岁男性，其因血便和腹胀就诊。患者被诊断为酒精性肝硬化。结肠镜检查显示横结肠靠近肝曲处有一条扩张且扭曲的静脉曲张，有渗血、交通支和“红色征”，提示急性出血。对于食管静脉曲张最有用的干预措施是内镜下套扎（EBL），进一步成功地对出血的结肠静脉曲张进行了止血。初始治疗后 1 个月，结肠静脉曲张几乎消失，被溃疡取代。EBL 治疗结肠静脉曲张极为罕见。文献中仅报道过 1 例类似病例，但作为急性结肠静脉曲张出血的 EBL 干预措施，似乎是安全且有效的。类似病例：第 2 例经内镜套扎治疗。
