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特发性结肠静脉曲张出血的管理

Management of Bleeding due to Idiopathic Colonic Varices.

作者信息

Ravikulan Abhimati, Gearry Richard, Kubovy Jan

机构信息

Department of Gastroenterology, Christchurch Hospital, Christchurch, New Zealand.

Canterbury District Health Board, Christchurch, New Zealand.

出版信息

ACG Case Rep J. 2025 Aug 1;12(8):e01791. doi: 10.14309/crj.0000000000001791. eCollection 2025 Aug.

Abstract

Lower gastrointestinal bleeding due to idiopathic colonic varices (ICV) is very rare. We present a 66-year-old man with recurrent hematochezia but without history of liver disease or portal hypertension. Colonoscopy revealed extensive varices throughout the colon. There was no biochemical or radiological evidence of cirrhosis or portal hypertension. The underlying etiology of ICV is unknown, and management of this condition is challenging without standardized treatment protocols. Nonselective beta-blockers could be considered despite the unknown ICV pathophysiology and their effect in this clinical entity. The successful management in our case included immediate endoscopic treatment and secondary prophylaxis with carvedilol.

摘要

特发性结肠静脉曲张(ICV)所致下消化道出血非常罕见。我们报告一例66岁男性,反复出现便血,但无肝脏疾病或门静脉高压病史。结肠镜检查发现全结肠广泛静脉曲张。没有肝硬化或门静脉高压的生化或影像学证据。ICV的潜在病因尚不清楚,在没有标准化治疗方案的情况下,这种疾病的治疗具有挑战性。尽管ICV的病理生理学尚不清楚及其在该临床实体中的作用,但仍可考虑使用非选择性β受体阻滞剂。我们病例的成功治疗包括立即内镜治疗和使用卡维地洛进行二级预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/12316347/26693845c7d2/ac9-12-e01791-g001.jpg

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