{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:06:27Z","timestamp":1753877187195,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Caecal varices are extremely rare with poorly defined management due to paucity of data. A 52-year-old man was diagnosed with a 3-day history of melena with a background of chronic liver disease and non-steroidal anti-inflammatory use. Investigations revealed anaemia with haemoglobin of 62\u00a0g\/L, liver function derangement (Gamma-glutamyl transferase 251\u00a0U\/L, alanine transaminase 40\u00a0U\/L, bilirubin 84 umol\/L, alkaline phosphatase 85\u00a0U\/L), coagulopathy (International Normalized Ratio 1.6) and acute kidney injury (Creatinine 285 umol\/L). Gastroscopy demonstrated no signs of upper gastrointestinal bleeding or portal hypertension. A large volume haematochezia occurred necessitating resuscitation with massive transfusion protocol, and colonoscopy was abandoned in favour of computerized tomography (CT) angiography, which revealed a large varix feeding the caecum. Urgent laparotomy and a right hemicolectomy was performed with application of abdominal vacuum dressing. The hemicolectomy sample was opened on back table demonstrating large caecal varix causing intraluminal bleeding. The patient was stabilized in intensive care, and a further laparotomy was performed 2 days later where an end ileostomy was formed. Caecal varices have been reported in literature with management via trans-jugular intrahepatic portosystemic shunt, endoscopically or conservatively with beta-blockade. Here we present, to the best of the author\u2019s knowledge, the first reported case of successful surgical management of caecal varices.<\/jats:p>","DOI":"10.1093\/jscr\/rjad438","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:43:44Z","timestamp":1691138624000},"source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of isolated caecal varices presenting with massive lower gastrointestinal haemorrhage: a case report and review of the literature"],"prefix":"10.1093","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0293-7314","authenticated-orcid":false,"given":"Wanyang","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Surgery, St John of God Subiaco Hospital , Subiaco, WA 6008 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4534-2795","authenticated-orcid":false,"given":"Benjamin M","family":"Mac Curtain","sequence":"additional","affiliation":[{"name":"Department of Surgery, St John of God Subiaco Hospital , Subiaco, WA 6008 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Acute Surgical Unit, Fiona Stanley Hospital , Murdoch, WA 6150 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"2023080408433430100_ref1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/00004836-199406000-00014","article-title":"Colonic findings in cirrhotics with portal hypertension. A prospective colonoscopic and histological study","volume":"18","author":"Scandalis","year":"1994","journal-title":"J Clin Gastroenterol"},{"key":"2023080408433430100_ref2","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1159\/000322884","article-title":"Cecal varices presenting as anemia: case report and review of the literature","volume":"4","author":"El-Masry","year":"2010","journal-title":"Case Rep Gastroenterol"},{"key":"2023080408433430100_ref3","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1002\/hep.510280434","article-title":"Management of ectopic varices","volume":"28","author":"Norton","year":"1998","journal-title":"Hepatology"},{"key":"2023080408433430100_ref4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.gii.2012.08.001","article-title":"Diagnosis and management of ectopic varices","volume":"1","author":"Akhter","year":"2012","journal-title":"Gastrointest Interv"},{"key":"2023080408433430100_ref5","doi-asserted-by":"crossref","first-page":"e00315","DOI":"10.14309\/crj.0000000000000315","article-title":"A therapeutic approach to cecal varices","volume":"7","author":"Kudaravalli","year":"2020","journal-title":"ACG Case Rep J"},{"key":"2023080408433430100_ref6","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/jgh3.12733","article-title":"A case report of an endoscopic approach to life-threatening cecal variceal hemorrhage","volume":"6","author":"MacFarlane","year":"2022","journal-title":"JGH Open"},{"key":"2023080408433430100_ref7","first-page":"690","article-title":"Large cecal varices as cause of lower gastrointestinal bleeding","volume":"116","author":"B\u00fcchter","year":"2019","journal-title":"Dtsch Arztebl Int"},{"key":"2023080408433430100_ref8","article-title":"Massive cecal variceal hemorrhage treated with transjugular intrahepatic portosystemic shunt with right colic vein and ileocolic vein embolization","volume":"11","author":"Mehta","year":"2019","journal-title":"Cureus"},{"key":"2023080408433430100_ref9","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1572-0241.2003.07202.x","article-title":"Isolated cecal varices as the source of massive lower GI bleeding in a patient with cirrhosis","volume":"98","author":"Klein","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"2023080408433430100_ref10","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/110241500750009591","article-title":"Acute gastrointestinal bleeding from caecal varicosities","volume":"166","author":"Hashmonai","year":"2000","journal-title":"Eur J Surg"},{"key":"2023080408433430100_ref11","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1155\/1996\/65719","article-title":"Masswe colonic haemorrhage from a solitary caecal varix","volume":"9","author":"Shaper","year":"1996","journal-title":"HPB Surg"},{"key":"2023080408433430100_ref12","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1038\/nrgastro.2009.167","article-title":"Diagnosis and management of lower gastrointestinal bleeding","volume":"6","author":"Barnert","year":"2009","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2023080408433430100_ref13","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1093\/gastro\/gou027","article-title":"Isolated non-hemorrhagic cecal varices","volume":"2","author":"Haddad","year":"2014","journal-title":"Gastroenterology Report"},{"key":"2023080408433430100_ref14","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/0002-9610(71)90457-0","article-title":"Varices of the appendix and cecum","volume":"122","author":"Mikat","year":"1971","journal-title":"Am J Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2023\/8\/rjad438\/51036389\/rjad438.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2023\/8\/rjad438\/51036389\/rjad438.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:43:58Z","timestamp":1691138638000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjad438\/7236913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjad438","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,8]]},"article-number":"rjad438"}}