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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. May 14, 2026; 32(18): 118499
Published online May 14, 2026. doi: 10.3748/wjg.v32.i18.118499
Anastomotic colonic varices after colectomy treated by obliteration via a transhepatic portal approach: A case report
Daisuke Tomita, Masayoshi Yamamoto, Masato Wakamatsu, Ryo Shibayama, Yusuke Maeda, Kosuke Hiramatsu, Yutaka Hanaoka, Shigeo Toda, Masashi Ueno, Shuichiro Matoba, Hiroya Kuroyanagi
Daisuke Tomita, Masato Wakamatsu, Ryo Shibayama, Yusuke Maeda, Kosuke Hiramatsu, Yutaka Hanaoka, Shigeo Toda, Masashi Ueno, Shuichiro Matoba, Hiroya Kuroyanagi, Department of Gastroenterological Surgery, Toranomon Hospital, Minato-ku 1058470, Tokyo, Japan
Masayoshi Yamamoto, Department of Radiology, Teikyo University Hospital, Itabashi-ku 1738606, Tokyo, Japan
Shuichiro Matoba, Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Omori Medical Center, Ota-ku 1438541, Tokyo, Japan
Co-first authors: Daisuke Tomita and Masayoshi Yamamoto.
Author contributions: Tomita D and Yamamoto M conceived the study and wrote the manuscript and they contribute equally to this study as co-first authors; Tomita D, Yamamoto M, Wakamatsu M, Shibayama R and Maeda Y contributed to the operation, follow-up, design, and coordination; Hiramatsu K, Hanaoka Y, Toda S, Ueno M, Matoba S and Kuroyanagi H aided in interpreting the results and supervised the project; all the authors have read and approved the final version of the manuscript and all authors agree with the contents of this manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Daisuke Tomita, MD, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku 1058470, Tokyo, Japan. dai0127027@gmail.com
Received: January 5, 2026
Revised: February 2, 2026
Accepted: February 24, 2026
Published online: May 14, 2026
Processing time: 122 Days and 22.3 Hours
Core Tip

Core Tip: Colonic anastomotic varices are extremely rare, particularly in patients without cirrhosis or portal hypertension, and optimal management has not been established. We describe a unique case of recurrent bleeding from transverse colonic anastomotic varices after colectomy, in which several endoscopic attempts at hemostasis were unsuccessful. Angiography revealed localized venous congestion at the anastomosis, prompting targeted embolization using a transhepatic interventional radiological approach. This case underscores the need to consider anastomotic varices as a potential late postoperative bleeding source and shows that coordinated treatment planning across multiple specialties is essential for selecting the most appropriate therapeutic strategy.

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