Massive colonic haemorrhage from a solitary caecal varix

A 51 year old lady with chronic active hepatitis presented with massive lower gastrointestinal tract bleeding. Angiography demonstrated a solitary varix in the caecum which was found at laparotomy to be entering the bowel wall at the site of adhesion from a previous appendicectomy. The portal pressure was found to be raised. A right hemicolectomy stopped the blood loss, but she subsequently died of liver failure. Solitary colonic varices associated with adhesions are extremely rare and their optimal management has not been established.