Cecal Varices Presenting as Anemia: Case Report and Review of the Literature

Since the original description of colonic varices in 1954 [N Engl J Med 1954;250:434-438], fewer than 100 cases have been reported in the literature. Particularly, even fewer cases of cecal varices have been reported. More than 75% of these cases have been due to portal hypertension. Our objective is to contribute a rare case with an uncommon presentation to the medical literature. We present the case of a 53-year-old male with hepatitis C and hepatitis B liver cirrhosis who presented for outpatient colonoscopy. The indication for colonoscopy was bright red blood per rectum and iron deficiency anemia. A significant amount of varices were noted in the cecum and proximal ascending colon. No endoscopic evidence of colonic bleeding was noted. This is the first reported case of cecal varices not presenting with massive lower gastrointestinal bleeding.