Abstract
A 51-year-old man with alcoholic liver cirrhosis was hospitalized for treatment of rectal varices. 3D-CT revealed that the rectal varices’ inflow vessel was the superior rectal vein─branching from a mesenteric vein─and outflow vessels were the middle and inferior rectal vein draining into the internal iliac vein. The diameter of the inferior mesenteric vein was thinner than that of the left gastric vein. Therefore, it was speculated that the variceal blood flow rate would be low, and endoscopic injection sclerotherapy (EIS) was selected as the treatment method. EIS was performed using 5% ethanolamine oleate with iopamidol. Endoscopic varicealography during injection sclerotherapy (EVIS) clearly showed the rectal varices, superior rectal vein, and inferior mesenteric vein. After treatment, complete embolization of the rectal varices and inflow vessels was confirmed by contrast enhanced CT, and endoscopy revealed disappearance of the rectal varices. This case of rectal varices was successfully treated using EIS.
