Hemodynamic evaluation of rectal varices by color Doppler ultrasonography: a case report.
A 69-year-old man with liver cirrhosis was admitted to our hospital with general fatigue. Colonoscopy revealed risky red color sign-positive enlarged tortuous rectal varices. Endoscopic injection sclerotherapy (EIS) was performed three times weekly using 5% ethanolamine oleate with iopamidol; the total amount of sclerosant was 7 ml. Images of rectal varices and the outflowing vessel from rectal varices were obtained via color Doppler ultrasonography before EIS, and fast Fourier transform analysis showed a continuous flow with a frequency shift of 276.6 Hz. We successfully performed EIS for this patient, having effective varicealography. After EIS, colonoscopy revealed shrinkage of the varices in the rectum, and color Doppler indicated an extreme decrease of blood flow in the rectal varices. In conclusion, color Doppler is a useful noninvasive modality for detecting rectal varices and for evaluating the therapeutic effects of EIS.
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan. m.nakanowatari@ja-hokkaidoukouseiren.or.jp.
Masayuki
M
Nakanowatari
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Takahiro
T
Sato
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Katsu
K
Yamazaki
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Jun
J
Akaike
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Tomohiro
T
Arakawa
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Yasuaki
Y
Kuwata
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Takumi
T
Ohmura
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Yoshiyasu
Y
Karino
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Jouji
J
Toyota
Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo, Sapporo, Hokkaido, 060-0033, Japan.
Toshihiro
T
Suga
color Doppler; endoscopic injection sclerotherapy; portal hypertension; rectal varices