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Ectopic ileal varices associated with recurrent bleeding: report of a case
Satoshi Ambiru1, Shunta Nakamura, Yasushi Mandai
1Department of Surgery, National Health Insurance Oami Hospital, 884-1 Tomita, Oamishirasato, Sanbu, Chiba, 299-3221, Japan.
Abstract:
Bleeding from ectopic varices of the ileum associated with portal hypertension is occasionally life-threatening. However, it is not easy to make an accurate preoperative diagnosis. A 62-year-old woman presented with hematochezia and anemia. Conventional examinations could not locate the bleeding point, but subsequent capsule endoscopy indicated gastrointestinal bleeding from hemorrhaging ileal varices. Contrast-enhanced abdominal computed tomography, three-dimensioned abdominal computed tomography, and mesenteric angiography demonstrated the presence of ileal and right ovarian varices. The patient then underwent an exploratory laparotomy which confirmed these findings, and resection of the affected ileum and right ovary was performed safely. Capsule endoscopy should be a diagnostic option for patients with obscure gastrointestinal bleeding, and ileal varices should be considered as one of the differential diagnoses.
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