N74: Idiopathic Pan-Colonic Varices Found Incidentally In A Young Patient With A Hepatic Flexure Tumor: A Rare Occurrence And A Challenging Surgical Management

O. AlZamzami, L. AlArfaj, H. AlOmran



Aim: Reporting the case of colon tumor in the presence of pancolonic varices and the surgical management we elected to do.

Method: Literature review

Results: Colonic varices is a rare entity and in majority of cases results from portal vein hypertension. It is even rarer when these lesions develop without an underlying hepatic or portal vein disease, termed, idiopathic colonic varices with less than 40 cases reported in the literature. Familial idiopathic colonic varices have also been described, where more than one family member is affected. These lesions could present an incidental finding, however, many cases presenting with lower GI bleeding were recognised in the literature, but no case was reported with a colonic tumor. Hereby we report a case of a 24 years old gentleman who presented   with a history of acute abdominal pain and anemia. CT and Colonoscopy showed evidence of hepatic flexure mass, proved to be adenocarcinoma on histological examination, with an incidental finding of pancolonic varices. The patient has two relatives with pan-colonic varices on colonoscopy, but no history of colonic tumors. He underwent right hemicolectomy with uneventful recovery. To our knowledge, this is the first case reported with coexistence of extensive idiopathic colonic varices and colonic tumor.