Endoscopic band ligation in management of bleeding rectal varices in patients with liver cirrhosis

ABSTRACT

Mucosal and vascular changes in portal hypertensive colopathy are part the spectrum found throughout the gastrointestinal tract in patients with portal hypertension. The colonic lesions themselves, are usually asymptomatic and clinically insignificant, except anorectal varices which may be presented by acute or chronic lower gastrointestinal bleeding. Rectal varcies in patients with portal hypertension deserve more appertain, more evaluation and better understanding. Was to evaluate the efficacy of endoscope band ligation as a maneuver for treatment of bleeding rectal varices. This study was performed on 25 cirrhotic patients who had bleeding per-rectum due to rectal varics. Endoscopic variceal ligation [EVL] was performed every two weeks from 1 to 3 times and the patients were followed for three momths. Endoscopic band ligation was effective in controlling the rectal bleeding in all cases. After EVL for rectal varices, colonoscopy revealed ulcers and shrinkage of the varices in the rectum in all patients. Minimal bleeding from ulcers occurred in three paients during follow up. EVL for bleeding rectal varices is an effective long term management