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Two patients are described with chronic liver disease and portal hypertension in association with ulcerative colitis for which colectomy and ileostomy had been performed. Both patients developed bleeding from the varices situated around the ileostomy stoma and one also bled from the oesophageal varices. Each had a successful portacaval shunt performed because of this bleeding.
The occurrence of such ileal varices is uncommon, but is important as a manifestation of portal hypertension. Although it can usually be easily controlled by local measures, portal-systemic shunt should always be considered, particularly as such patients are also very likely to bleed from oesophageal varices.