title: Recurrent massive haemorrhage from an endoscopically inevident isolated rectal varix.
abstract: Anorectal varices are identified endoscopically in up to 40% of patients with liver cirrhosis [Misra SP, Dwivedi M, Misra V. Prevalence and factors influencing haemorrhoids, anorectal varices, and colopathy in patients with portal hypertension. Endoscopy 1996;28:340-5] but are an infrequent cause of bleeding and their management remains controversial. We present a patient with chronic hepatitis C virus infection who developed recurrent haemorrhage from an isolated, endoscopically inevident rectal varix in the absence of clinical or endoscopic evidence of portal hypertension. The difficulties in diagnosis and management of anorectal varices are highlighted.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236/16B, Beirut 1107 2020, Lebanon.
authors.forename: C
authors.initials: C
authors.lastname: Azar
authors.forename: M
authors.initials: M
authors.lastname: Khalifeh
authors.forename: M A
authors.initials: MA
authors.lastname: Al-Kutoubi
authors.forename: A I
authors.initials: AI
authors.lastname: Sharara
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic; D016099:Endoscopy, Gastrointestinal; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000209:etiology* / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D008297:Male; D008642:Mesenteric Veins; D012007:Rectum / Q000098:blood supply*; D012008:Recurrence; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis* / Q000628:therapy