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Case Reports
. 2025 Aug 1;12(8):e01791.
doi: 10.14309/crj.0000000000001791. eCollection 2025 Aug.

Management of Bleeding due to Idiopathic Colonic Varices

Abhimati Ravikulan  1   2 , Richard Gearry  1   2   3   4   5 , Jan Kubovy  1   2
Affiliations
Case Reports

Management of Bleeding due to Idiopathic Colonic Varices

Abhimati Ravikulan et al. ACG Case Rep J. .

Abstract

Lower gastrointestinal bleeding due to idiopathic colonic varices (ICV) is very rare. We present a 66-year-old man with recurrent hematochezia but without history of liver disease or portal hypertension. Colonoscopy revealed extensive varices throughout the colon. There was no biochemical or radiological evidence of cirrhosis or portal hypertension. The underlying etiology of ICV is unknown, and management of this condition is challenging without standardized treatment protocols. Nonselective beta-blockers could be considered despite the unknown ICV pathophysiology and their effect in this clinical entity. The successful management in our case included immediate endoscopic treatment and secondary prophylaxis with carvedilol.

Keywords: Colonoscopy; endoscopic intervention; endoscopy; idiopathic colonic varices; lower GI bleeding.

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Figures

Figure 1.
Figure 1.
CT coronal view showing colitis. Arrows showing colon wall thickening/oedema likely reflecting varices.
Figure 2.
Figure 2.
CT axial view showing colitis. Arrows showing colon wall thickening/oedema likely reflecting varices.
Figure 3.
Figure 3.
Colonic varices.
Figure 4.
Figure 4.
Culprit varix with stigmata of bleeding. Arrow showing cuprit varix with bleeding point.
Figure 5.
Figure 5.
Culprit varix clipped through the scope clip.
Figure 6.
Figure 6.
Terminal ileum varices.
See this image and copyright information in PMC

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