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CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2023; 06(01): 037-041
DOI: 10.1055/s-0042-1750137
Case Report

Acute Colonic Variceal Bleeding in a Cirrhotic Patient Treated by Modified Balloon-occluded Retrograde Transvenous Obliteration: A Case Report

Ahmad L. F. Yasin
1   Department of Diagnostic and Interventional Radiology, Hamad Medical Corporation, Doha, Qatar
,
Rahil Hussein Kassamali 
1   Department of Diagnostic and Interventional Radiology, Hamad Medical Corporation, Doha, Qatar
,
Mohammad Khader 
1   Department of Diagnostic and Interventional Radiology, Hamad Medical Corporation, Doha, Qatar
,
Omran Almokdad
1   Department of Diagnostic and Interventional Radiology, Hamad Medical Corporation, Doha, Qatar
,
Ali Raza Barah 
1   Department of Diagnostic and Interventional Radiology, Hamad Medical Corporation, Doha, Qatar
,
Ahmad Omar
1   Department of Diagnostic and Interventional Radiology, Hamad Medical Corporation, Doha, Qatar
› Author Affiliations Funding None.
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Abstract

Colonic varices are an uncommon type of ectopic varices that can occur due to underlying liver cirrhosis and portal hypertension. They form a very rare cause of lower gastrointestinal bleeding that can result in massive hemorrhage. We present a 38-year-old woman with a background of ulcerative colitis complicated by primary sclerosing cholangitis-induced liver cirrhosis presenting with fresh rectal bleeding. The colonoscopy failed to identify the source of bleeding. Then, computed tomography scan showed multiple dilated tortuous venous collaterals around the descending colon that extended into the colonic submucosa and drained via the left ovarian vein representing colonic varices. She underwent balloon-occluded retrograde transvenous obliteration (BRTO), which successfully embolized these varices with no significant complications. Despite there being no established management guidelines for colonic variceal bleeding, BRTO is a minimally invasive procedure that can be considered as good option for the treatment of these varices, especially when other alternatives are not applicable.

Keywords

BRTO - bleeding - liver cirrhosis - colonic varices - ectopic varices

Ethical Approval

This case was approved by the Medical Research Centre in Qatar before submission.




Publication History

Article published online:
11 July 2022

© 2022. Indian Society of Gastrointestinal and Abdominal Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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