Management of rectal varices in portal XXXX .

@entity1 @entity101 @entity548 @entity1003 @entity6315
Rectal varices are portosystemic collaterals that form as a complication of portal @entity101 , their prevalence has been reported as high as 94% in @entity1 with extrahepatic @entity6315 . The diagnosis is typically based on lower endoscopy (colonoscopy or sigmoidoscopy). However, endoscopic ultrasonography has been shown to be superior to endoscopy in diagnosing rectal varices. Color Doppler ultrasonography is a better method because it allows the calculation of the velocity of blood flow in the varices and can be used to predict the @entity548 risk in the varices. Although rare, @entity548 from rectal varices can be life threatening. The management of @entity1 with rectal variceal @entity548 is not well established. It is important to ensure hemodynamic stability with blood transfusion and to correct any @entity1003 prior to treating the @entity548 varices. Endoscopic injection sclerotherapy has been reported to be more effective in the management of active @entity548 from rectal varices with less rebleeding rate as compared to endoscopic band ligation. Transjugular intrahepatic portsystemic shunt alone or in combination with embolization is another method used successfully in control of @entity548 . Balloon-occluded retrograde transvenous obliteration is an emerging procedure for management of gastric varices that has also been successfully used to treat @entity548 rectal varices. Surgical procedures including suture ligation and porto-caval shunts are considered when other methods have failed.
