Background: Varices of the lower gastrointestinal tract are known as a sign of portal hypertension
or portal vein obstruction. The authors report on the first Hungarian patient with
pan-colonic varices without portal hypertension.
Case-report: A 31-year-old male patient was admitted to our department after massive
gastrointestinal bleeding requiring transfusion. Varices from rectum to cecum were
revealed by colonoscopy. Histological examination of the liver biopsy showed no signs
of cirrhosis or fibrosis. Esophago-gastro-duodenoscopy, abdominal ultrasonography
and angiography were normal; specifically they did not confirm the suspicion of the
portal hypertension or obstruction of superior or inferior mesenteric vein. Endoscopic
therapy was not performed, propranolol was started. The massive bleeding has not repeated
since the discharge of the patient from hospital.
Conclusion: Based on our experience and a review of medical literature the patients with idiopathic
colonic varices have better prognosis than those whose arise secondary to portal hypertension
and the conservative medical therapy (beta blocker) seems to be the first choice in
such cases.
