A CASE OF PORTAL HYPERTENSIVE COLOPATHY WITH GASTROINTESTINAL BLEEDING FROM VASCULAR ECTASIAS

Abstract

A 75-year-old woman, who had been followed up due to liver cirrhosis for 13 years, was admitted to our hospital because of severe iron deficiency anemia (Hb 5.5 g/dl) and positive fecal occult blood. The examination of the gastrointestinal tract revealed some vascular ectasias in the terminal ileum, cecum and ascending colon. Blood pool image of the abdomen after injection of 99mTc-RBC demonstrated hot accumulation corresponding to the ileocecal region. From these findings, the vascular ectasias were thought to be the source of bleeding. Therefore, endoscopic mucosal resection of these lesions was performed. After this treatment, fecal occult blood test became negative and the anemia had subsided. We should take into consideration that portal hypertensive colopathy is a potential source of gastrointestinal bleeding in patients with liver cirrhosis.