Case Report
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World J Gastroenterol. Apr 28, 2006; 12(16): 2629-2632
Published online Apr 28, 2006. doi: 10.3748/wjg.v12.i16.2629
A case of idiopathic colonic varices: A rare cause of hematochezia misconceived as tumor
Joung-Ho Han, Won-Joong Jeon, Hee-Bok Chae, Seon-Mee Park, Sei-Jin Youn, Seok-Hyung Kim, Il-Hun Bae, Sang-Jeon Lee
Joung-Ho Han, Won-Joong Jeon, Hee-Bok Chae, Seon-Mee Park, Sei-Jin Youn, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
Seok-Hyung Kim, Department of Pathology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
Il-Hun Bae, Department of Radiology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
Sang-Jeon Lee, Department of General Surgery, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
Author contributions: All authors contributed equally to the work.
Correspondence to: Sei Jin Youn, MD Departments of Internal Medicine, College of Medicine, Chungbuk National University, Gaeshindong 62, Heungdukgu, Cheongju, Republic of Korea. sjyoun@chungbuk.ac.kr
Telephone: +82-43-269-6057 Fax: +82-43-273-3252
Received: November 1, 2005
Revised: January 9, 2006
Accepted: January 14, 2006
Published online: April 28, 2006
Abstract

Colonic varices are a very rare cause of lower gastrointestinal bleeding. Fewer than 100 cases of colonic varices, and 30 cases of idiopathic colonic varices (ICV) have been reported in the English literature. Among these 30 cases of ICV, 19 cases were diagnosed by angiography, and 7 operated cases were diagnosed later as ileocecal vein deficit, hemangioma, and idiopathic in 1, 1, 5 cases, respectively. We report the case of a 24-year-old man who suffered from multiple episodes of hematochezia of varying degree at the age of 11 years. He had severe anemia with hemoglobin of 21 g/L. On colonoscopy, tortuously dilated submucosal vein and friable ulceration covered with dark necrotic tissues especially at the rectosigmoid region were seen from the rectum up to the distal descending colon. It initially appeared to be carcinoma with varices. Mesenteric angiographic study suggested a colonic hemangioma. Low anterior resection was done due to medically intractable and recurrent hematochezia. Other bowel and mesenteric vascular structures appeared normal. Microscopic examination revealed normal colonic mucosa with dilated veins throughout the submucosa and serosa without representing new vessel growth. Taken all of these findings together, the patient was diagnosed as ICV. His postoperative course was uneventful.

Keywords: Idiopathic colonic varices; Hematochezia; Colon cancer; Hemangioma