The aim of this paper was, first, to show in a case control study that in alcoholic cirrhotic patients colonic vascular ectasias (VE) are a complication of portal hypertension and, second, to establish in a histomorphometric study that colonic vascular ectasias and rectal varices (RV) are only endoscopic features of a new entity: portal hypertensive colopathy, the pathologic basis of which is colonic mucosal capillary ectasia. In the case control study, for each case, three age- and sex-matched controls selected from consecutive patients were used. Sixteen alcoholic cirrhotic patients, 12 men, 4 women (mean age ±sd: 62±10 years) had colonic vascular ectasias. The prevalence of esophageal varices (88% vs 44%,P<0.005), esophageal="" varices="">5 mm) (44% vs 12.5%,P<0.01), previous="" history="" of="" bleeding="" from="" esophageal="" varices="" (44%="" vs="">P<0.005), and="" rectal="" varices="" (63%="" vs="">P<0.001) was="" significantly="" greater="" in="" cases="" with="" colonic="" vascular="" ectasias="" than="" in="" controls="" without="" colonic="" vascular="" ectasias.="" the="" relative="" risk="" of="" colonic="" vascular="" ectasias="" in="" alcoholic="" cirrhotic="" patients="" with="" esophageal="" varices="" versus="" cirrhotic="" patients="" without="" esophageal="" varices="" was="" 14.4="" (95%="" confidence="" interval="" 2.8–75.3).="" in="" the="" histomorphometric="" study,="" cirrhotic="" patients="" with="" vascular="" ectasias="" and/or="" rectal="" varices="" had="" a="" significantly="" higher="" mean="" diameter="" of="" vessels="" (20.3±1.5="">m vs 18.7±1.6 m,P<0.05) and="" a="" higher="" mean="" cross-sectional="" vascular="" area="" (2143±396="">m² vs 1676±345 m²,P<0.05) than="" cirrhotic="" patients="" without="" vascular="" ectasias="" and/or="" rectal="" varices.="" these="" results="" suggest="" that="" colonic="" vascular="" ectasias="" seem="" to="" be="" a="" complication="" of="" portal="" hypertension="" and="" that="" colonic="" vascular="" ectasias="" and="" rectal="" varices="" are="" endoscopic="" features="" of="" a="" new="" entity="" the="" portal="" hypertensive="">