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Extensive varices of ileocecum. Report of a case
S Sugiyama1, K Yashiro, K Nagasako
1Institute of Gastroenterology, Tokyo Women's Medical College, Japan.
Insights
A rare case of intestinal bleeding was caused by colonic varices due to a total deficiency of the ileocecal vein. This led to abnormal blood flow through the right colon varices.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Anatomy
Background:
- Intestinal bleeding can stem from various causes, including vascular abnormalities.
- Colonic varices are uncommon and often associated with portal hypertension.
Observation:
- A patient presented with significant intestinal bleeding.
- Colonoscopy revealed varices in the cecum.
- Angiography demonstrated reduced blood flow in the ileum to ascending colon region.
- Surgical exploration confirmed varices but found no ileocecal vein.
Findings:
- The patient had a complete absence of the ileocecal vein.
- This anatomical deficit rerouted blood flow, causing the colonic varices.
- The varices likely facilitated blood return through collateral abdominal veins.
Implications:
- This case highlights a unique cause of colonic varices and intestinal bleeding.
- It underscores the importance of considering rare venous anomalies in diagnosing gastrointestinal hemorrhage.
- The findings contribute to understanding venous drainage variations in the right colon.
Abstract:
A man was admitted to our hospital because of intestinal reddish bleeding. Colonic varices were found at the cecum by colonoscopy. Angiography of the superior mesenteric artery showed that blood vessels were scant from the end of the ileum to the ascending colon. An operative view revealed the varices, but there was no trace of the ileocecal vein. This case, presenting a deficit of the ileocecal vein, indicated that the blood flow could not return via the ileocecal vein, and therefore there was an outflow through the varices to the surrounding intestine or abdominal veins. Such a case is probably unrepresented in the literature because it was caused by the total deficiency of the ileocecal vein and it was in the right colon.