Vesical Varices: An Unusual Cause of Hematuria

Abstract

Portal hypertension is a common complication of cirrhosis and may lead to the formation of venous collateral channels. Usually, varices due to portal hypertension develop in the lower esophagus, stomach, rectum, or other parts of the digestive tract. Extraintestinal ectopic varices are rare. Here, we present a patient with ectopic urinary bladder varices, who presented with hematuria and symptomatic anemia. The bleeding was managed with minimally invasive endovascular approach.

Keywords

bladder - ectopic - schistosomiasis - albumin - cirrhosis - glue

Publikationsverlauf

Artikel online veröffentlicht:
06. November 2024

• References

• 1 Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med 2010; 362 (09) 823-832
• 2 Norton ID, Andrews JC, Kamath PS. Management of ectopic varices. Hepatology 1998; 28 (04) 1154-1158
• 3 Helmy A, Al Kahtani K, Al Fadda M. Updates in the pathogenesis, diagnosis and management of ectopic varices. Hepatol Int 2008; 2 (03) 322-334
• 4 Kinkhabwala M, Mousavi A, Iyer S, Adamsons R. Bleeding ileal varicosity demonstrated by transhepatic portography. AJR Am J Roentgenol 1977; 129 (03) 514-516
• 5 Khouqeer F, Morrow C, Jordan P. Duodenal varices as a cause of massive upper gastrointestinal bleeding. Surgery 1987; 102 (03) 548-552
• 6 Kim M, Al-Khalili R, Miller J. Vesical varices: an unusual presentation of portal hypertension. Clin Imaging 2015; 39 (05) 920-922
• 7 Khan MQ, Al-Momen S, Alghssab A. Duodenal varices causing massive lower gastrointestinal hemorrhage. Ann Saudi Med 1999; 19 (05) 440-443
• 8 Khan AA, Sarwar S, Alam A. et al. Ectopic intestinal varices as a rare cause of lower gastrointestinal haemorrhage. J Coll Physicians Surg Pak 2003; 13 (09) 526-527
• 9 Sano K, Shuin T, Takebayashi S. et al. A case of vesical varices as a complication of portal hypertension and manifested gross hematuria. J Urol 1989; 141 (02) 369-371
• 10 Gaspar Y, Detry O, de Leval J. Vesical varices in a patient with portal hypertension. N Engl J Med 2001; 345 (20) 1503-1504
• 11 Herden U, Seiler CA, Candinas D, Schmid SW. Bladder tamponade due to vesical varices during orthotopic liver transplantation. Transpl Int 2008; 21 (11) 1105-1106
• 12 Rahoui M, Rami B, Hassen K. Vesical varices: an uncommon cause of gross hematuria in young men. Ann Med Surg (Lond) 2022; 74: 103286
• 13 Bruet A, Fingerhut A, Lopez Y. et al. Ileal varices revealed by recurrent hematuria in a patient with portal hypertension and Mekong schistosomiasis. Am J Gastroenterol 1983; 78 (06) 346-350
• 14 Hallamore SL, Grills RJ, Neerhut G, Lawrentschuk N. Submucosal vesical varicosities causing hematuria and retention of urine in pregnancy: cystovarix. Am J Obstet Gynecol 2007; 196 (05) e29-e30
• 15 Koshy CG, Govil S, Shyamkumar NK, Devasia A. Bladder varices–rare cause of painless hematuria in idiopathic retroperitoneal fibrosis. Urology 2009; 73 (01) 58-59
• 16 Lim DH, Kim DH, Kim MS, Kim CS. Balloon-occluded percutaneous transhepatic obliteration of isolated vesical varices causing gross hematuria. Korean J Radiol 2013; 14 (01) 94-96
• 17 Sivalingam S, Manikam R, Razack AH, Mohamad N. Endoscopic injection of Histoacryl® in the treatment of recurrent hematuria secondary to bladder varices. Int J Case Rep Imag 2011; 2 (10) 6-9
• 18 Parmar K, Rathi S, Khanna A. et al. Portal hypertensive vesiculopathy: a rare cause of hematuria and a unique management strategy. Urology 2018; 115: e7-e8
• 19 Wei ZJ, Zhu X, Yu HT, Liang ZJ, Gou X, Chen Y. Severe hematuria due to vesical varices in a patient with portal hypertension: a case report. World J Clin Cases 2021; 9 (18) 4810-4816
• 20 Saffouri G, Razumilava N, Gettman M, Kamath P. TIPS to treat gross hematuria: 1076. Am J Gastroenterol 2013; 108: S321
• 21 Lipsich J, Rojas L, Alonso J. et al. Massive hematuria due to portal hypertension in a child with bladder augmentation for vesical exstrophy. J Pediatr Urol 2008; 4 (03) 236-238