Bleeding ileal conduit stomal varices: diagnosis and management using transjugular transhepatic angiography and embolization.
An uncommon complication of ileal conduit urinary diversion is bleeding varices at the stoma site. Variceal formation is a complication of portal hypertension, which is most commonly due to intrinsic liver disease. Problematic recurrent bleeding is usually managed locally or by portosystemic shunt. We report a case of recurrent, massive ileal conduit variceal hemorrhage in a patient without a significantly elevated portosystemic gradient. Therefore, this patient was not a candidate for a shunt procedure. Using a transjugular transhepatic approach to the portal vein, the varices were embolized to stasis without any complications. The patient has subsequently experienced no further bleeding episodes.
Lashley
D B
DB
Division of Urology and Dotter Interventional Institute, Oregon Health Sciences University, Portland 97201, USA.
Saxon
R R
RR
Fuchs
E F
EF
Chin
D H
DH
Lowe
B A
BA
D004621:Embolization, Therapeutic; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D007082:Ileum / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D054047:Surgical Stomas; D014547:Urinary Diversion / Q000009:adverse effects*; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy