International Journal of Clinical & Medical Images

 A 65 years old male patient presented in the outpatient department of the Digestive Disease-II with the chief complains of the passage of blood with stool for 3 months, mild abdominal pain, and occasional constipation. The patient has a habit of regular smoking and alcohol intake. On examination, the he was found anemic but generally healthy with diffuse mild abdominal tenderness. He was non-diabetic and non-hypertensive with no history of hepatic disease or surgery.

His blood routine examination revealed mild anemia, biochemistry for the liver function tests were not significant. Ultrasound detected Hepatomegaly with no other associated changes. The fecal occult blood test was positive. Upper Gastrointestinal endoscopy was normal, but the colonoscopy detected multiple dilated veins 30 cm distal to the anus with fresh hemorrhage (Figures 1- 3). For further evaluation, an abdominal CT was done, but no abnormality was detected. The patient was advised for sclerotherapy of the dilated varices.