¹Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi Gastroenteroloji Cerrahisi Kliniği, Ankara Isolated intractable massive lower gastrointestinal bleeding from anorectal varices is rarely seen in portal hypertension. In this case report we present a seventy two years old female who had chronic liver disease for seven years with massive anorectal variceal bleeding, failure of endoscopic treatment modalities and treated succesfully with the construction of inferior mesenterico caval shunt. This is the first case reported in Turkey. (Turkish J Vasc Surg 2007; 16(1):41-44) Keywords : Inferior mesenteric vein, inferior mesocaval shunt, portal hypertension