Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report

Scuderi, Giuseppe and Macrì, Antonio and Pagano, Giovanni and Biondo, Giovanni and Armaleo, Francesco and Crescenti, Fabio and Piazzese, Enrico and Famulari, Ciro (2006) Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report. Il giornale di chirurgia, 27 (4). pp. 145-148. ISSN 1971-145x

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Introduction. Rectal varices, primitive or secondary to hypertensive or thrombotic disorders of mesenteric-portal circle, represent an uncommon cause of lower digestive bleeding. The presence of rectal varices associated to idiopathic venous portal thrombosis represents a distinct nosologic entity, with important clinical and therapeutic problems related to it. Case report. Patient of young age, with positive anamnesis for primitive rectal varicies, admitted to our department for a serious rettorragy. The laboratory underlined moderate anaemia and the endoscopy documented the presence of multiple rectal varices, without evident signs of bleeding; the endoscopy documented the presence of two esophageal small varicose cords F1. The hepatobiliary sonography and the portography showed the massive thrombosis of the portal vein. The new serious episode of rectal bleeding induced us to subject the patient to a surgical operation of Hartmann recto-sigmoid resection. Conclusion. Because of the slight number of reported cases of primitive rectal varices and because of the scattering of many dates it’s difficult to draw an univocal diagnostic and therapeutic algorithm. Clinical framing and subsequent therapeutic approach rise often up from personal experience rather than well defined guidelines. The treatment is controversial, time by time many therapeutic options are reported either conservative or interventist. The failure of conservative therapy and the recurrent episodes of bleeding give indication to surgical treatment, that is represented by Hartmann colonic resection and/or the porto-systemic shunts in the cases of portal hypertension; in our case we made colonic resection sec. because of lapsed performing status of the patient.

Item Type: Article
Uncontrolled Keywords: Primitive rectal varices, Idiopathic portal thrombosis, Lower digestive bleeding; Varici rettali primitive, Trombosi portale idiopatica, Emorragia digestiva bassa
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Chiara D'Arpa
Date Deposited: 11 Jul 2013 11:04
Last Modified: 11 Jul 2013 11:04
URI: http://eprints.bice.rm.cnr.it/id/eprint/5233

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