Diagnosis and Hemodynamics of Ectopic Varices

  • Norihito WatanabeEmail author
  • Seiichiro Kojima
  • Shinji Takashimizu


Varices may form in any part of the gastrointestinal tract from the esophagus to the colon, when portal pressure increases. The most common site of ectopic varices is the rectum followed by the duodenum. Other sites of varices are the small intestine, colon, gall bladder, anastomotic site, and stoma. The incidence of rectal varices has been increasing in recent years. Patients have to be monitored for possible rectal varices especially after the treatment of esophageal and gastric varices. While cirrhosis is the most frequent underlying disorder in Japan, extrahepatic portal obstruction associated with thrombosis, tumor, or pancreatitis is common in the USA and Europe. Endoscopy to directly observe the variceal lesion is most frequently used for diagnosis. Computed tomography and magnetic resonance imaging are required for understanding the hemodynamic profiles of ectopic varices regardless of their sites. Ectopic varices may be fatal once bleeding occurs because of the high blood flow rate and volume. However, bleeding is considered infrequent in general. Ectopic varices are an important clinical issue in portal hypertension, and the incidence is expected to increase. The pathophysiology of ectopic varices needs to be elucidated to establish the diagnosis and treatment.


Ectopic varices Diagnosis Endoscopy Diagnostic imaging Collateral hemodynamics 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Norihito Watanabe
    • 1
    Email author
  • Seiichiro Kojima
    • 1
  • Shinji Takashimizu
    • 1
  1. 1.Division of GastroenterologyTokai University Hachioji HospitalHachioji, TokyoJapan

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