Abstract
A 45-year-old man, a heavy drinker, felt abdominal pain as it was forced to be streched when he stood up 3 days before admission. Abdominal distention and dizziness on standing were followed, and he was seen at the hospital. Abdominal CT scan showed findings of liver cirrhosis and bloody ascites. Dilatation of the paraumbilical vein and a collateral growth atthe ascending colon which might be associated with portal hypertension werealso revealed. On the next day after admission, he developed back pain, felt sick and broke into cold sweat. Additional abdominal CT scan showed active bleeding mainly at the Morison pouch. Intraabdominal bleeding due to rupture of ectopic varices atthe ascending colon was diagnosed and an emergency laparotomy was performed. Upon laparotomy we found moniliform dilatation of the veins from the ascending colon to the retroperitoneum, a varix portion of which had ruptured and bled. The ruptured portion was ligated and removed.
The rupture of ectopic varices due to portal hypertension and subsequent intraabdominal bleeding is rare. Patients with this condition often die before they undergo surgery and the prognosis is poor. In treating intraabdominal bleeding in patients with liver cirrhosis, rupture of ectopic varices can be a probable diagnosis so thatearly diagnosis and treatments are essential.
