Portal Hypertension with Bleeding Vaginal Varices

Abstract

A 40-yr. old woman with Laennec''s cirrhosis and portal hypertension bled recurrently from varices in the vaginal vault. Portal hypertension was confirmed by splenic pulp manometry. Portal system origin of these vessels was demonstrated by vaginal varix pressure, differential sampling of blood from the varix and a peripheral vein after oral administration of glucose and sodium iodide 131, celiac axis arteriography and vaginal varicogram. The aberrant varicose vessels drained blood from the portal system into the right hypogastric vein through postoperative adhesions between a distal loop of small intestine and the wall of the vagina. The collateral vessels were ligated and excised with immediate benefit to the patient.