Anorectal varicosities, also called anorectal or rectal varices, are abnormally enlarged veins in and around the rectum and anus. They usually develop as collateral blood vessels when portal hypertension causes increased pressure in the portal venous system, most commonly in people with advanced liver disease or other conditions affecting portal blood flow.
Anorectal varices may remain asymptomatic, but they can cause significant or potentially life-threatening rectal bleeding when a varix ruptures. Prompt evaluation is particularly important in patients with portal hypertension who develop unexplained rectal bleeding. Early diagnosis also allows doctors to identify and manage the underlying cause of portal hypertension and reduce the risk of recurrent bleeding.
Causes
Risk Factors
Endoscopic treatment:Endoscopic band ligation or injection sclerotherapy may be used to control bleeding from rectal varices in selected patients. The choice depends on the size and location of the varices and the treating specialist's assessment.
EUS-guided therapy : Endoscopic ultrasound with colour Doppler can help locate varices and guide targeted treatment. Selected patients may undergo coil embolisation or injection of a haemostatic agent in specialised centres, may be considered in specialised centres.
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Interventional radiology: The procedure aims to block the abnormal veins responsible for bleeding.
Transjugular intrahepatic portosystemic shunt (TIPS): In selected patients with significant portal hypertension and recurrent or uncontrolled bleeding, TIPS may decompress the portal venous system.









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