Transjugular intrahepatic portosystemic shunt for bleeding stomal varices associated with chronic portal vein occlusion: long-term angiographic, hemodynamic, and clinical follow-up.
The efficacy of the transjugular intrahepatic portosystemic shunt procedure (TIPS) in controlling refractory hemorrhage from stomal varices at the mucocutaneous junction has been previously described, but the durability of this procedure for this indication is unknown. Conservative therapy may be unsuccessful in preventing recurrent hemorrhage. Some authors believe that portosystemic shunting is the treatment of choice for patients with bleeding stomal varices who are good surgical candidates, because of the low incidence of recurrent bleeding and the longest survival. We report the 39-month angiographic and hemodynamic follow-up, and the 48-month clinical follow-up of a patient with refractory hemorrhage from stomal varices and coexistent chronic portal vein occlusion successfully treated with a TIPS procedure.
Morris
C S
CS
Department of Radiology, Fletcher Allen Health Care, University of Vermont College of Medicine, Burlington, USA.
Najarian
K E
KE
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007081:Ileostomy; D011169:Portal Vein / Q000000981:diagnostic imaging*; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy; D015607:Stents; D054047:Surgical Stomas / Q000098:blood supply*; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*