A Case of Lower GI Bleeding from Portal Hypertensive Colopathy Successfully Treated
Ji Song Ko, M.D., Ju Sang Kim, M.D., Chee Ho Noh, M.D., Do Young Kim, M.D., Jong
Department of Internal Medicine, College of Medicine, The Catholic University of Korea,
Abstract
Cirrhotic patients with portal hypertension are often found to have changes in their
colonic mucosa. Such mucosal changes are termed portal hypertensive colopathy. Most patients with
portal hypertension remained asymptomatic but some may show massive bleeding. The mainstay of
treatment for portal hypertensive gastropathy include non-surgical methods such as octreotide
injection, endoscopic hemostasis, and interventional methods such as TIPS. However, treatment for
portal hypertensive colopathy remained unresolved. The authors here report a case of a 41 year old male
with liver cirrhosis admitted for fever and abdominal pain, who reported an episode of hematochezia in
the course of admisssion period. Subsequent colonoscopy revealed angiodysplasia-like lesions
throughout the entire colon. We observed that such lesions were the source of hematochezia and that
direct clipping with octreotide injection was successful in controlling the bleeding. (Korean J Gastrointest
Endosc 2004;28:97101)
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