Massive Hemorrhage From Rectal Varices Secondary to Portal Hypertension in Alcoholic Cirrhosis

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Conference Proceeding - Restricted Access

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A 37-year old male with past medical history of alcoholic cirrhosis (MELD 40) with known portal hypertension and prior episodes of variceal bleeding presented with acute hypotension. He had been admitted to the ICU for decompensated cirrhosis. He became acutely hypotensive after a bloody bowel movement and on examination he was found to have significant rectal hemorrhage with initiation of massive transfusion, multiple vasopressors, PCC, and TXA. Due to hemodynamic instability, patient underwent bedside examination and suture ligation of hemorrhagic variceal complexes. With this case we will discuss the pathophysiology, management, and treatment of rectal varices and pulmonary hypertension.


American Society of Anesthesiology Annual Meeting, San Diego, CA, October 8-12, 2021.