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Cecal varices presenting as anemia: case report and review of the literature.

El-Masry M, Hu R - Case Rep Gastroenterol (2010)

Bottom Line: More than 75% of these cases have been due to portal hypertension.Our objective is to contribute a rare case with an uncommon presentation to the medical literature.No endoscopic evidence of colonic bleeding was noted.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Gastroenterology, UCLA-Olive View Medical Center, Sylmar, Calif., and David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.

ABSTRACT
Since the original description of colonic varices in 1954 [N Engl J Med 1954;250:434-438], fewer than 100 cases have been reported in the literature. Particularly, even fewer cases of cecal varices have been reported. More than 75% of these cases have been due to portal hypertension. Our objective is to contribute a rare case with an uncommon presentation to the medical literature. We present the case of a 53-year-old male with hepatitis C and hepatitis B liver cirrhosis who presented for outpatient colonoscopy. The indication for colonoscopy was bright red blood per rectum and iron deficiency anemia. A significant amount of varices were noted in the cecum and proximal ascending colon. No endoscopic evidence of colonic bleeding was noted. This is the first reported case of cecal varices not presenting with massive lower gastrointestinal bleeding.

No MeSH data available.


Related in: MedlinePlus

Varices noted in the cecum.
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Figure 1: Varices noted in the cecum.

Mentions: Recent complete blood count prior to colonoscopy revealed a hemoglobin of 11.5 g/dl, hematocrit of 34.6%, and a platelet count of 36,000 with a MCV of 81.3. The patient's INR was 1.4 and albumin 3.8. The patient had positive serologies proving both infection with hepatitis B and C. The patient's hepatitis C viral load was undetectable. Recent abdominal ultrasound was notable for hepatomegaly, nodular and heterogeneous in consistency, massive splenomegaly, and ascites. Colonoscopy was significant for internal hemorrhoids as well as cecal and proximal ascending colon varices without any endoscopic evidence of bleeding (fig. 1).


Cecal varices presenting as anemia: case report and review of the literature.

El-Masry M, Hu R - Case Rep Gastroenterol (2010)

Varices noted in the cecum.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3037982&req=5

Figure 1: Varices noted in the cecum.
Mentions: Recent complete blood count prior to colonoscopy revealed a hemoglobin of 11.5 g/dl, hematocrit of 34.6%, and a platelet count of 36,000 with a MCV of 81.3. The patient's INR was 1.4 and albumin 3.8. The patient had positive serologies proving both infection with hepatitis B and C. The patient's hepatitis C viral load was undetectable. Recent abdominal ultrasound was notable for hepatomegaly, nodular and heterogeneous in consistency, massive splenomegaly, and ascites. Colonoscopy was significant for internal hemorrhoids as well as cecal and proximal ascending colon varices without any endoscopic evidence of bleeding (fig. 1).

Bottom Line: More than 75% of these cases have been due to portal hypertension.Our objective is to contribute a rare case with an uncommon presentation to the medical literature.No endoscopic evidence of colonic bleeding was noted.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Gastroenterology, UCLA-Olive View Medical Center, Sylmar, Calif., and David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.

ABSTRACT
Since the original description of colonic varices in 1954 [N Engl J Med 1954;250:434-438], fewer than 100 cases have been reported in the literature. Particularly, even fewer cases of cecal varices have been reported. More than 75% of these cases have been due to portal hypertension. Our objective is to contribute a rare case with an uncommon presentation to the medical literature. We present the case of a 53-year-old male with hepatitis C and hepatitis B liver cirrhosis who presented for outpatient colonoscopy. The indication for colonoscopy was bright red blood per rectum and iron deficiency anemia. A significant amount of varices were noted in the cecum and proximal ascending colon. No endoscopic evidence of colonic bleeding was noted. This is the first reported case of cecal varices not presenting with massive lower gastrointestinal bleeding.

No MeSH data available.


Related in: MedlinePlus