The value of the ultrasonic microprobe in the detection and treatment of rectal varices: a case report.

An 81-year-old woman with idiopathic portal hypertension was admitted to our hospital with anal bleeding. Colonoscopy revealed tortuous rectal varices extending 5 cm proximal of the dentate line. The rectal varices were considered to be the most likely cause of the bleeding, although the precise site could not be determined. The vessel images of the intramural rectal varices were clearly delineated using the water repletion method via an ultrasonic microprobe (UMP). The peri-rectal collateral veins and communicating veins between the intramural rectal varices and the peri-rectal collateral veins could be observed via the UMP. We performed endoscopic injection sclerotherapy (EIS) three times using 5% ethanolamine oleate, the total amount of sclerosant used being 5 ml. Ten days after EIS, colonoscopy revealed both ulcers and shrinkage of the varices in the rectum. The UMP revealed the disappearance of variceal vessels and peri-rectal collateral veins.