Endoscopic localization and management of colonic bleeding in patients with portal hypertension

In patients with portal hypertension, vascular lesions in the colon may dev elop that have been collectively termed portal hypertensive colopathy. Endo scopic diagnosis of these lesions is now established, but the management of hemorrhage from them is not. We report five cases of endoscopic management of bleeding colonic vascular lesions in patients with portal hypertension. Endoscopy data from January 1, 1996 to June 30, 1999 identified 158 patien ts with portal hypertension who underwent colonoscopy. Forty-Eve of these 1 58 patients had portal hypertensive colopathy (angiodysplasias or varices). Those who had colonoscopic hemostasis attempted were identified and review ed. Five patients underwent colonoscopic intervention for bleeding. Initial hemostasis was achieved in four of five cases. Repeat endoscopic intervent ion was necessary in three of the four cases. One patient required surgery. In patients with portal hypertension, colonic vascular lesions may develop . Hemorrhage from these lesions is rare. Colonoscopy is effective for local ization and diagnosis of bleeding vascular lesions and permits simultaneous hemostatic intervention.