Although anorectal varices are a common complication of portal hypertension, there is no consensus on the optimal management of this condition. We present a retrospective case series of ten consecutive patients who underwent endoscopic variceal ligation (EVL) for rectal varices associated with hematochezia, at a single tertiary care center between 1995 and 2008. EVL was performed with a standard esophageal varices multi-shot band ligation device attached to a standard video upper endoscope. Of the ten patients who underwent EVL for rectal varices associated with hematochezia, four of the patients (40 %) experienced a rebleeding event; in three this was controlled with repeat EVL, but one patient died of fatal hemorrhage from the rectal varices. There were no procedural complications. EVL may be an emerging therapeutic option for the management of hematochezia associated with rectal varices in patients with portal hypertension. Prospective studies are needed to determine the safety and efficacy of EVL in these patients.
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