Management of Bleeding due to Idiopathic Colonic Varices

Lower gastrointestinal bleeding due to idiopathic colonic varices (ICV) is very rare. We present a 66-year-old man with recurrent hematochezia but without history of liver disease or portal hypertension. Colonoscopy revealed extensive varices throughout the colon. There was no biochemical or radiological evidence of cirrhosis or portal hypertension. The underlying etiology of ICV is unknown, and management of this condition is challenging without standardized treatment protocols. Nonselective beta-blockers could be considered despite the unknown ICV pathophysiology and their effect in this clinical entity. The successful management in our case included immediate endoscopic treatment and secondary prophylaxis with carvedilol.