Abstract
We experienced two cases of small varices of the ascending colon, presenting with recurrent massive hematochezia, requiring frequent blood transfusions. Case 1 was a 49-year-old man who had the superior mesenteric vein obstruction due to pancreatic head cancer. Case 2 was a 68-year-old woman who had hepatitis C virus-related liver cirrhosis with the superior mesenteric vein and portal vein thrombosis. In both cases, abdominal, contrast-enhanced, computed tomography (CT) showed collateral veins around the ascending colon and colonoscopy revealed faint varices with a tiny red dot on their surfaces (“red dot sign”). Endoscopic variceal ligation (EVL) was effective in achieving successful hemostasis in both patients. Contrast-enhanced CT should be performed to evaluate collateral veins if mesenteric vein occlusion is suspected. EVL is useful and reasonable for colonic varices, especially when focusing on the “red dot sign”.
