title: The role of minimally invasive percutaneous embolisation technique in the management of bleeding stomal varices.
abstract: BACKGROUND
  Stomal varices can develop in patients with ostomy in the setting of portal hypertension. Bleeding from the stomal varices is uncommon, but the consequences can be disastrous. Haemorrhage control measures that have been described in the literature include pressure dressings, stomal revision, mucocutaneous disconnection, variceal suture ligation and sclerotherapy. These methods may only serve to temporise the stomal bleeding and have a high risk of recurrent bleed. While transjugular intrahepatic porto-systemic shunting has been advocated as the treatment of choice in patients with underlying liver cirrhosis, histoacryl glue or coil embolisation has been successfully employed in patients who are not suitable candidates for TIPS.
  
  
  RESULTS
  Direct percutaneous embolisation of the dominant varices was performed successfully under ultrasound and fluoroscopic guidance in two patients using a combination of coils and histoacryl glue.
  
  
  RESULTS
  While transjugular intrahepatic porto-systemic shunting has been advocated as the treatment of choice in patients with underlying liver cirrhosis, histoacryl glue or coil embolisation has been successfully employed in patients who are not suitable candidates for TIPS.
  
  
  CONCLUSIONS
  Direct percutaneous embolisation is a safe and effective treatment for stomal varices in selected patients.
authors.affiliation: Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, University of Sydney, St Leonards, Sydney, New South Wales, Australia.
authors.forename: Albert C H
authors.initials: AC
authors.lastname: Kwok
authors.forename: Frank
authors.initials: F
authors.lastname: Wang
authors.forename: Richard
authors.initials: R
authors.lastname: Maher
authors.forename: Timothy
authors.initials: T
authors.lastname: Harrington
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Gananadha
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hugh
authors.forename: Jaswinder S
authors.initials: JS
authors.lastname: Samra
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D054047:Surgical Stomas / Q000009:adverse effects* / Q000098:blood supply*; D014648:Varicose Veins / Q000209:etiology* / Q000628:therapy*
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