[Rupture of ileal varices in a type C liver cirrhosis patient: a case report].
A 74-year-old woman was admitted to our hospital with recurrent massive lower gastrointestinal bleeding. She had a history of type C liver cirrhosis and appendectomy, and had undergone endoscopic ligation of esophageal varices one year before. Three-dimensional CTA revealed ileal varices in the right lower quadrant of the abdomen. Superior mesenteric arteriography demonstrated varices at the corresponding area and collateral veins from the superior mesenteric vein to the right ovarian vein. Ileal varices were diagnosed and ileal resection was performed. At surgery, exposed vessels were present at the mucosal surface of the resected specimen and they were thought to be the origin of hemorrhage. In conclusion, bleeding from small intestinal varices, though uncommon, should be considered when the origin of melena is unidentified in a patient with liver cirrhosis.
Suzuki
Takahisa
T
Department of Gastroenterogy, Toyota Memorial Hospital, Japan. takahisa@mail.toyota.co.jp
Murayama
Mutsumi
M
Shinoda
Masataka
M
Takashi
Hitomi
H
Uchiyama
Isako
I
Morise
Kazuhiro
K
Usami
Akihisa
A
Tsuji
Hideki
H
Haruki
Nobuhiro
N
Tashiro
Kazuhiro
K
Ando
Takafumi
T
Goto
Hidemi
H
D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007082:Ileum / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000150:complications*; D012422:Rupture, Spontaneous; D014648:Varicose Veins / Q000150:complications*