Direct percutaneous embolization of bleeding stomal varices.
Stomal variceal bleeding can develop in patients with underlying cirrhosis and portal hypertension. Most patients are best treated with transjugular intrahepatic portosystemic shunt (TIPS) creation because this addresses the underlying problem of portal hypertension. However, some patients are not good candidates for TIPS creation because they have end-stage liver disease or encephalopathy. We describe such a patient who presented with recurrent bleeding stomal varices, which was successfully treated with percutaneous coil embolization. The patient had bleeding-free survival for 1 month before death from unrelated causes.
Naidu
Sailen G
SG
Department of Radiology, Division of Interventional Radiology, Mayo Clinic Arizona, Mayo Clinic Hospital, Phoenix, AZ 85054, USA. naidu.sailen@mayo.edu
Castle
Erik P
EP
Kriegshauser
J Scott
JS
Huettl
Eric A
EA
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D015653:Cystectomy; D004621:Embolization, Therapeutic / Q000379:methods*; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006417:Hematuria / Q000209:etiology / Q000628:therapy*; D006501:Hepatic Encephalopathy / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D054047:Surgical Stomas / Q000009:adverse effects*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects*