Case of Bleeding Ileal Varices after a Colectomy Diagnosed by Capsule Endoscopy.
10.4166/kjg.2018.71.6.349
- Author:
Chang Joon PARK
1
;
Bong Eun LEE
;
Hye Kyung JEON
;
Gwang Ha KIM
;
Geun Am SONG
;
Sang Hwa KO
;
So Jeong LEE
;
Do Youn PARK
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. bongsul@hanmail.net
- Publication Type:Case Report
- Keywords:
Gastrointestinal hemorrhage;
Capsule endoscopy
- MeSH:
Aged;
Capsule Endoscopy*;
Colectomy*;
Colonoscopy;
Dilatation;
Emergency Service, Hospital;
Endoscopy;
Female;
Follow-Up Studies;
Gastrointestinal Hemorrhage;
Hemorrhage*;
Humans;
Ileum;
Laparotomy;
Liver Cirrhosis;
Melena;
Rectal Neoplasms;
Varicose Veins*
- From:The Korean Journal of Gastroenterology
2018;71(6):349-353
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of bleeding ileal varices associated with intra-abdominal adhesions after colectomy which was successfully diagnosed using capsule endoscopy. A 77-year-old woman visited the emergency department for several episodes of melena. She had a medical history of neoadjuvant chemo-radiation therapy and subsequent surgery for rectal cancer 6 years previously. Conventional diagnostic examinations including upper endoscopy, colonoscopy, and abdominal computed tomography could not detect any bleeding focus, however, following capsule endoscopy revealed venous dilatations with some fresh blood in the distal ileum, indicating bleeding ileal varices. The patient underwent exploratory laparotomy and the affected ileum was successfully resected. No further gastrointestinal bleeding occurred during the 6 months follow-up. Small intestinal varices are important differential for obscure gastrointestinal bleeding especially in patients with a history of abdominal surgery in the absence of liver cirrhosis, and capsule endoscopy can be a good option for diagnosing small intestinal varices.
