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It Runs in the Family: A Rare Case of Familial Idiopathic Colonic Varices
Rakahn Haddadin1, Ozoemena Akah1, Maryam Ameen2
1Department of Internal Medicine, HCA Healthcare, MountainView Hospital, 2880 N Tenaya Way, Las Vegas, NV 89128, USA.
Insights
This study reports a rare case of familial idiopathic colonic varices (CV) in a woman, complicated by bleeding after polyp removal. It highlights the importance of considering CV in unexplained lower GI bleeding.
Area of Science:
- Gastroenterology
- Hepatology
- Vascular Medicine
Background:
- Colonic varices (CV) are rare vascular anomalies.
- Typically associated with portal hypertension from liver disease, pancreatitis, or malignancy.
- Familial idiopathic CV, without these common causes, is exceptionally uncommon.
Observation:
- A 57-year-old female presented with melena, diagnosed with idiopathic CV during colonoscopy.
- No history of liver/pancreatic disease, NSAID or anticoagulant use.
- A family history of CV was subsequently identified.
Findings:
- The case involves familial idiopathic colonic varices.
- Complication arose from polyp removal during colonoscopy.
- The patient experienced severe lower gastrointestinal bleeding.
Implications:
- Highlights the diagnostic challenge of CV in the absence of typical risk factors.
- Emphasizes the need to consider CV in unexplained lower GI bleeding.
- Underscores the potential for life-threatening hemorrhage from CV.
Background:
Colonic varices (CV) remain an extremely rare condition, the usual cause of which is portal hypertension due to liver disease, chronic pancreatitis or malignancy. Here we present a case of familial idiopathic CV in a middle-aged female, complicated by a polyp removal during colonoscopy.
Case Presentation:
A 57-year-old female with a past medical history of 5 months of melena, polyps and hemorrhoids diagnosed with idiopathic CV during diagnostic colonoscopy. She had no prior history of liver disease, pancreatic disease, non-steroidal anti-inflammatory drugs (NSAID) use, or blood thinner use. She was later found to have a family history of the condition.
Conclusion:
The rarity of this case is of particular concern for clinicians due to its life threatening complication of severe lower gastrointestinal bleed - a true medical emergency. This is particularly difficult in the absence of usual predisposing triggers. Differential diagnoses should be considered in patients that present with rectal bleeding of unknown cause.
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