Embolization of bleeding stomal varices by direct percutaneous approach.
Stomal varices can occur in patients with stoma in the presence of portal hypertension. Suture ligation, sclerotherapy, angiographic embolization, stoma revision, beta blockade, portosystemic shunt, and liver transplantation have been described as therapeutic options for bleeding stomal varices. We report the case of a 21-year-old patient with primary sclerosing cholangitis and colectomy with ileostomy for ulcerative colitis, where stomal variceal bleeding was successfully treated by direct percutaneous embolization. We consider percutaneous embolization to be an effective way of treating acute stomal bleeding in decompensated patients while awaiting decisions regarding shunt procedures or liver transplantation.
Arulraj
Ramakrishnan
R
Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK. arulraas@yahoo.com
Mangat
Kamarjit S
KS
Tripathi
Dhiraj
D
D015209:Cholangitis, Sclerosing / Q000150:complications*; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007081:Ileostomy; D008103:Liver Cirrhosis / Q000150:complications*; D008111:Liver Function Tests; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D010690:Phlebography; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult