External Prolapsed Rectal Varices Treated with Visual and Endoscopic Sclerotherapy Based on Four-Dimensional Computed Tomography Hemodynamic Assessment: a Case Report

March 1, 2026KanzoOpen Access

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Key Points

This case report aims to describe a novel approach for treating bleeding external rectal varices using sclerotherapy informed by hemodynamic assessment.
Conducted a hemodynamic evaluation using four-dimensional computed tomography (4D CT).
Administered visual and endoscopic sclerotherapy with n-butyl-2-cyanoacrylate.
Attempted venous embolization under double balloon occlusion, which was unsuccessful.
Identified multiple outflow routes for rectal varices via 4D CT hemodynamic assessment.
Successfully achieved hemostasis with endoscopic sclerotherapy after persistent bleeding from rectal varices.
A unique strategy using detailed hemodynamic profiling was implemented for the treatment.

Case report demonstrates successful treatment of bleeding rectal varices using sclerotherapy after hemodynamic evaluation.

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Suzuki et al. (2026) studied this question.

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