Colonic varices: a rare complication of pancreatic cancer
- PDF / 1,041,581 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 60 Downloads / 170 Views
CASE REPORT
Colonic varices: a rare complication of pancreatic cancer Masatoshi Murakami1 · Nao Fujimori1 · Yoshihiro Nagao2 · Tomoharu Yoshizumi2 · Kazuhide Matsumoto1 · Sho Yasumori1 · Katsuhito Teramatsu1 · Yu Takamatsu1 · Takamasa Oono1 · Yoshihiro Ogawa1 Received: 2 July 2020 / Accepted: 27 August 2020 © Japanese Society of Gastroenterology 2020
Abstract A 55-year-old man was diagnosed with pancreatic cancer of the uncus and received chemotherapy (modified FOLFIRINOX). Ten months later, he was admitted to our hospital with massive lower gastrointestinal bleeding. Contrast-enhanced CT showed ascending colon varices caused by the occlusion of the superior mesenteric vein (SMV) due to pancreatic cancer invasion. Colonoscopy revealed tortuous varices with red spots in the ascending colon. The patient received blood transfusions and was discharged; however, he was hospitalized for recurrent massive lower gastrointestinal bleeding 3 months later. During this readmission, we performed the transileocolic vein obliteration method due to SMV stenosis and the absence of an obvious shunt. He experienced an uneventful post-operative recovery, and contrast-enhanced CT after 2 months revealed no recurrence of colonic varices. Ectopic varices are portosystemic venous collaterals resulting from portal hypertension occurring in any locations other than the esophagogastric region. Colonic varices have rarely been reported before. Patients with pancreatic cancer may present with gastrointestinal bleeding caused by tumor bleeding or esophagogastric varices; however, ectopic varices such as colon varices, a rare complication of pancreatic cancer, should be considered in patients with obscure gastrointestinal bleeding. Keywords Colonic varices · Ectopic varices · Pancreatic cancer · Transileocolic vein obliteration (TIO)
Introduction Ectopic varices are dilated portosystemic venous collaterals located in any locations other than the esophagogastric region. Among the ectopic varices, colonic varices are rarely reported, and colon varices related to pancreatic cancer are even less common. Although various treatments for ectopic varices, including those in the colon, have been reported, these procedures constitute only case reports. There is no systematic evidence on the treatments of ectopic varices, and no standard treatments for ectopic varices have yet been established. Therefore, a variety of methods should be considered as appropriate for each individual case. Herein, we present a case of massive lower gastrointestinal bleeding * Nao Fujimori [email protected]‑u.ac.jp 1
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3‑1‑1 Maidashi, Higashi‑ku, Fukuoka 812‑8582, Japan
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2
due to rupture of colonic varices treated successfully by the transileocolic vein obliteration (TIO) method.
Case report A 55-year-old man was diagnosed with unresectable loca
