Portal Hypertensive Colopathy with Pelvic Varices presenting as Severe Lower Gi Bleed treated with TIPSS
Murphy, S.F.; Durand, M.; McMorrow, J.P.; Meaney, J.F.; Guiney, M.
Irish Medical Journal 111(2): 696
2018
ISSN/ISBN: 0332-3102 PMID: 29952445 Document Number: 695876
We present the case of a 71-year-old lady with a background of significant alcohol intake who presented with frank lower gastrointestinal (GI) bleeding, lower abdominal pain and haemoglobin 6.3g/dL. CT abdominal angiogram showed right-sided colonic thickening, atrophic liver and enlarged superior mesenteric vein (SMV) and right-sided pelvic varix. This lead to a diagnosis of portal hypertensive colopathy secondary to alcoholic liver cirrhosis. The patient failed conservative management and underwent a Transjugular Intrahepatic Portosystemic Shunt (TIPSS) procedure. This lead to an immediate resolution of her lower-GI bleeding. Repeat CT at three weeks showed a decompressed SMV and resolution of the right-sided pelvic varix. The patient was discharged after three months following optimization of medical condition and social circumstances.