Massive lower gastrointestinal hemorrhage in patients with portal hypertensive enteropathy: a report of two cases.

Mucosal and vascular changes in the lower gastrointestinal tract occur commonly in patients with portal hypertension. Portal enteropathy, however, is usually asymptomatic, though occasionally clinically significant for chronic gastrointestinal bleeding. Massive hemorrhage has only rarely been described and its management is controversial. Even though more effective non-operative treatments are now available, an emergency porta-systemic shunt procedure remains an important option for selected patients. We report on two cases of massive lower gastrointestinal bleeding from portal hypertensive enteropathy secondary to post-viral cirrhosis.