Diagnosis and Endoscopic Treatments of Rectal Varices

Esophagogastric varices are considered to be the most common complication in patients with portal hypertension, while ectopic varices, that is, those outside of the esophagogastric region, are less common. Rectal varices represent portal systemic collaterals that are manifested as discrete dilated submucosal veins and constitute a pathway for portal venous flow between the superior rectal veins of the inferior mesenteric system and the middle inferior rectal veins of the iliac system. Rectal varices are an infrequent but potentially serious cause of hematochezia. Massive bleeding from rectal varices occurs rarely, with a frequency ranging from 0.5% to 3.6% (1-3). In this chapter, we describe the diagnostic modalities and endoscopic treatments for rectal varices in patients with portal hypertension.