Vaginal varices in post-menopausal woman: A rare entity

Post-menopausal bleeding occurs in 4-11% of post-menopausal women with the most common cause being endometrial atrophy followed by malignancies genital tract. Vaginal varices are a rare and usually seen pregnant women. They less than vulval varicosities which occur 2-4%of pregnancies. Other causes vaginal portal hypertension, pelvic congestion syndrome Klippel-Trenaunay syndrome. Here we report woman without any evidence liver disease nor A 71-year-old multipara presented complaints for 2 years. She gave typical history passage gush fresh blood spontaneous resolution within minutes. had these episodes at an interval to 3 weeks she underwent total abdominal hysterectomy. There was no malignancy histopathology. However, 7 months following surgery symptoms recurred. On examination not pale unremarkable except 3*3 cm bluish swelling anterior wall. Ultrasound doppler revealed increased vascularity around vagina. CT angiography performed showed varix draining into left internal iliac vein. The patient planned embolization transfemoral catheterization feeding vessel selectively embolized. Post -embolization resolved, discharged is currently asymptomatic. should be kept as differential especially when discharge consists blood. Early recognition treatment can also avoid unwanted hysterectomies.