title: Peristomal variceal bleeding treated by coil embolization using a percutaneous transhepatic approach.
abstract: Peristomal variceal bleeding due to portal hypertension is an entity that has rarely been reported with 3%-4% risk of death. A 68-year-old woman who had undergone a palliative colostomy (colorectal carcinoma) presented with a massive hemorrhage from the colostomy conduit. Considering her oncological status with medial and right hepatic veins thrombosis due to liver metastasis invasion, an emergency transhepatic coil embolization was successfully performed. Standard treatment modality for these cases has not been established. Percutaneous transhepatic coil embolization of varices is a safe and effective choice in patients who present with life threatening bleeding and exhibit contraindications to transjugular intrahepatic portosystemic shunt.
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Macello José Sampaio
authors.initials: MJ
authors.lastname: Maciel
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Osvaldo Ignácio
authors.initials: OI
authors.lastname: Pereira
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Joaquim Maurício
authors.initials: JM
authors.lastname: Motta Leal Filho
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Enio
authors.initials: E
authors.lastname: Ziemiecki Junior
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Susyanne Lavor
authors.initials: SL
authors.lastname: Cosme
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Moisés Amâncio
authors.initials: MA
authors.lastname: Souza
authors.affiliation: Macello José Sampaio Maciel, Osvaldo Ignácio Pereira, Joaquim Maurício Motta Leal Filho, Enio Ziemiecki Junior, Susyanne Lavor Cosme, Moisés Amâncio Souza, Francisco Cesar Carnevale, Radiology Department of Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil.
authors.forename: Francisco Cesar
authors.initials: FC
authors.lastname: Carnevale
keywords: Cirrhosis; Colostomy; Ectopic variceal bleeding; Hemostasis; Percutaneous transhepatic embolization; Stomal bleeding