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Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report.
G Chir. 2006 Apr; 27(4):145-8.GC

Abstract

INTRODUCTION

Rectal varices, primitive or secondary to hypertensive or thrombotic disorders of mesenteric-portal circle, represent an uncommon cause of lower digestive bleeding. The presence of rectal varices associated to idiopathic venous portal thrombosis represents a distinct nosologic entity, with important clinical and therapeutic problems related to it.

CASE REPORT

Patient of young age, with positive anamnesis for primitive rectal varices, admitted to our department for a serious recttorragy. The laboratory underlined moderate anaemia and the endoscopy documented the presence of multiple rectal varices, without evident signs of bleeding; the endoscopy documented the presence of two esophageal small varicose cords F1. The hepatobiliary sonography and the portography showed the massive thrombosis of the portal vein. The new serious episode of rectal bleeding induced us to subject the patient to a surgical operation of Hartmann recto-sigmoid resection.

CONCLUSION

Because of the slight number of reported cases of primitive rectal varices and because of the scattering of many dates it is difficult to draw an univocal diagnostic and therapeutic algorithm. Clinical framing and subsequent therapeutic approach rise often up from personal experience rather than well defined guidelines. The treatment is controversial, time by time many therapeutic options are reported either conservative or interventionist. The failure of conservative therapy and the recurrent episodes of bleeding give indication to surgical treatment, that is represented by Hartmann colonic resection and/or the porto-systemic shunts in the cases of portal hypertension; in our case we made colonic resection sec. because of lapsed performing status of the patient.

Authors+Show Affiliations

Università degli Studi di Messina, UOC di Chirurgia d'Urgenza e dei Trapianti d'Organo.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16768868

Citation

Scuderi, G, et al. "Hemorrhage From Primitive Rectal Varices in Patient With Idiophatic Thrombosis of Portal Vein: Case Report." Il Giornale Di Chirurgia, vol. 27, no. 4, 2006, pp. 145-8.
Scuderi G, Macrì A, Pagano G, et al. Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report. G Chir. 2006;27(4):145-8.
Scuderi, G., Macrì, A., Pagano, G., Biondo, G., Armaleo, F., Crescenti, F., Piazzese, E., & Famulari, C. (2006). Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report. Il Giornale Di Chirurgia, 27(4), 145-8.
Scuderi G, et al. Hemorrhage From Primitive Rectal Varices in Patient With Idiophatic Thrombosis of Portal Vein: Case Report. G Chir. 2006;27(4):145-8. PubMed PMID: 16768868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report. AU - Scuderi,G, AU - Macrì,A, AU - Pagano,G, AU - Biondo,G, AU - Armaleo,F, AU - Crescenti,F, AU - Piazzese,E, AU - Famulari,C, PY - 2006/6/14/pubmed PY - 2006/11/2/medline PY - 2006/6/14/entrez SP - 145 EP - 8 JF - Il Giornale di chirurgia JO - G Chir VL - 27 IS - 4 N2 - INTRODUCTION: Rectal varices, primitive or secondary to hypertensive or thrombotic disorders of mesenteric-portal circle, represent an uncommon cause of lower digestive bleeding. The presence of rectal varices associated to idiopathic venous portal thrombosis represents a distinct nosologic entity, with important clinical and therapeutic problems related to it. CASE REPORT: Patient of young age, with positive anamnesis for primitive rectal varices, admitted to our department for a serious recttorragy. The laboratory underlined moderate anaemia and the endoscopy documented the presence of multiple rectal varices, without evident signs of bleeding; the endoscopy documented the presence of two esophageal small varicose cords F1. The hepatobiliary sonography and the portography showed the massive thrombosis of the portal vein. The new serious episode of rectal bleeding induced us to subject the patient to a surgical operation of Hartmann recto-sigmoid resection. CONCLUSION: Because of the slight number of reported cases of primitive rectal varices and because of the scattering of many dates it is difficult to draw an univocal diagnostic and therapeutic algorithm. Clinical framing and subsequent therapeutic approach rise often up from personal experience rather than well defined guidelines. The treatment is controversial, time by time many therapeutic options are reported either conservative or interventionist. The failure of conservative therapy and the recurrent episodes of bleeding give indication to surgical treatment, that is represented by Hartmann colonic resection and/or the porto-systemic shunts in the cases of portal hypertension; in our case we made colonic resection sec. because of lapsed performing status of the patient. SN - 0391-9005 UR - https://www.unboundmedicine.com/medline/citation/16768868/Hemorrhage_from_primitive_rectal_varices_in_patient_with_idiophatic_thrombosis_of_portal_vein:_case_report_ L2 - http://www.giornalechirurgia.it/index.php?PAGE=article&ID=1124 DB - PRIME DP - Unbound Medicine ER -