Prominent vessels in the ascending colon. Ectopic varices are an unusual cause of gastrointestinal hemorrhage The clinician caring for patients with gastrointestinal bleeding must be aware of this entity, because diagnosis and management of ectopic varices differ from that of esophagogastric varices. Furthermore, the prognosis from bleeding ectopic varices may be poor with one study quoting 40% mortality at initial bleed from duodenal varices. It is important to differentiate anal varices from hemorrhoids: Anal varices collapse with digital pressure, whereas hemorrhoids do not. In patients with portal hypertension caused by obstruction of the portal or splenic veins, duodenal varices are more prevalent than in patients with intrahepatic portal hypertension. The prevalence is higher if angiography is used.
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