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Published on: June 18, 2020
Bleeding colonic varices controlled by propranolol
L G McAlpine1, G G Birnie, T E Hilditch
1Department of Medicine, Western Infirmary, Glasgow.
Scottish Medical Journal
|December 1, 1988
Summary
Sclerotherapy successfully treated esophageal varices bleeding in a patient with hepatic cirrhosis. Oral propranolol later prevented recurrent gastrointestinal bleeding from colonic varices.
Area of Science:
- Gastroenterology
- Hepatology
- Vascular Medicine
Background:
- Hepatic cirrhosis commonly leads to esophageal varices, a significant source of gastrointestinal hemorrhage.
- Management of variceal bleeding requires effective and sustained therapeutic strategies.
Observation:
- A 64-year-old male patient with hepatic cirrhosis presented with severe esophageal varices hemorrhage.
- Following successful sclerotherapy for esophageal varices, the patient experienced recurrent bleeding from colonic varices.
Findings:
- Sclerotherapy effectively obliterated the esophageal varices, preventing further upper gastrointestinal bleeding.
- Angiography and radionuclide imaging confirmed the presence of varices in the ascending colon.
- Oral propranolol therapy proved effective in preventing further episodes of gastrointestinal bleeding from colonic varices.
Implications:
- This case highlights the potential for varices to develop in non-esophageal locations in patients with advanced liver disease.
- It underscores the importance of considering and investigating non-esophageal varices in cirrhotic patients with recurrent gastrointestinal bleeding.
- Propranolol may serve as a valuable therapeutic option for managing bleeding from colonic varices in select patients.
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