Abstract
A 48-year-old male complained of colonic polyp and colitis. Barium enema showedelevated lesion traversing longitudinally and transversely, producing an exaggerated foldedappearance. Colonoscopic examination showed tortu.ous, partially nodular, bluish submucosal elevated lesion extended from the upper rectum to the terrninal ileum. Endoscopicultrasonography revealed luminal structures in the submu.cosal layer, corresponding to theelevated lesion. Endoscopic color doppler u.ltrasonography(ECDUS)demonstrated colorflow image of continuous wave Iin the submucosal layer. Therefore, we diagnosed as lowergastrointestinal(GI)varices in this case. Abdominal computed tomography scan andultrasonography showed no findings suggestive of portal hypertention. There were noabnormal findings at endoscopic examination of the upper GI tracts. Selective mesentericarteriography and portography via superior and inferior mesenteric arteries demonstratedneither abnormal arterio-venous communication nor portal occulusion. It was assumedthat the lower GI varices were due to a congenital vascular anomaly. Only 7 cases ofdiffuse lower GI varices without portal hypertention, including our case, have been reportedin Japan, and this case seems to be the first report of lower GI varices diagnosed by ECDUS.
