Endoscopic Study of Vascular Lesions of Colon in Portal Hypertension

Hung-Fei Tsai

The Second Department of Surgery, Juntendo University School of Medicine (Director: Prof. Shunji Futagawa)

Vascular lesions of the colon were studied endoscopically in 75 patients with portal hypertension. The 3 characteristic findings of colonoscopy in these patients and their incidence rates were: (1) colonic varices·blue vein: 46.7% (varices: 16%, blue vein: 30.7%), (2) tree-like dilated vessels: 85.3%, (3) vascular spider-like vessels: 6.7%. Clinically, among these findings, colonic varices·blue vein was the most important and its relation to each clinical factors was also elucidated as follows: The colonic varices to occur in the rectum (39.7%, 25/63), sigmoid colon (25.4%, 16/63) and cecum (15.9%, 10/63); from the viewpoint of pathogenectic entity, there was a higher incidence in the patients with extrahepatic portal vein occlusion (83.3%, 5/6) than in those with liver cirrhosis (41.3%, 26/63). Moreover, among the patients with the colonic varices·blue vein complication, there was a tendency for it to occur in patients with advanced esophageal varices of F3 and Ls; and for limited occurrence in those with liver cirrhosis, the same tendency was also found in patients with Child B·C and those with ICG-R15 values beyond 30%. Furthermore, A-V fistula (3) and aneurysm (1) were also present in 4 of 6 patients (66.7%) who bled during mesenteric angiography.

Key words
portal hypertension, colonic varices, colonoscopy, arteriovenous fistula, lower gastrointestinal bleeding

Reprint requests
Hung-Fei Tasi The Second Department of Surgery, Juntendo University School of Medicine
3-1-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
December 12, 1990

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