title: Bleeding due to ectopic varices in a urinary diversion: A multidisciplinary diagnostic and therapeutic challenge.
abstract: The ectopic varices in patients with portal hypertension are those that occur at any level of the gastrointestinal (GI) tract, regardless of the varices that occur at the esophageal level. These ectopic varices account for 2-5% of the causes of GI bleeding varices. The risk of bleeding is quadrupled compared to the esophagogastric area, with a mortality of up to 40%. The transjugular intrahepatic portosystemic shunt, should be considered in cases secondary to recurrent bleeding varices. We present a case report of an urological emergency of bleeding in a urinary diversion secondary to ectopic varices successfully treated through the placement of transjugular intrahepatic portosystemic shunt. The condition described here is rare, but important, as it can be a life-threatening complication of portal hypertension. This kind of complication should be known by urologic surgeons managing patients with urinary diversions.
authors.affiliation: Department of Urology, Hospital Universitario de La Princesa, Madrid, Spain. Universidad Autónoma de Madrid;
authors.forename: Eduardo Mariano Albers
authors.initials: EM
authors.lastname: Acosta
authors.affiliation: Department of Interventional & Vascular Radiology, Hospital Universitario de La Princesa, Madrid, Spain, Universidad Autónoma de Madrid.
authors.forename: Alfonsi Friera
authors.initials: AF
authors.lastname: Reyes
authors.affiliation: Department of Urology, Hospital Universitario de La Princesa, Madrid, Spain. Universidad Autónoma de Madrid;
authors.forename: Ricardo Brime
authors.initials: RB
authors.lastname: Menéndez
references.citation: Prog Urol. 2012 Feb;22(2):127-31
references.pmid: 22284598
references.citation: Hepatol Int. 2008 Sep;2(3):322-34
references.pmid: 19669261
references.citation: World J Gastroenterol. 2013 Aug 21;19(31):5035-50
references.pmid: 23964137
references.citation: Cardiovasc Intervent Radiol. 2006 Mar-Apr;29(2):216-9
references.pmid: 16284702
references.citation: Ostomy Wound Manage. 2007 Aug;53(8):20-2, 24, 26 passim
references.pmid: 17726209
references.citation: Tech Vasc Interv Radiol. 2013 Jun;16(2):158-75
references.pmid: 23830673
references.citation: Dis Colon Rectum. 1999 Dec;42(12):1581-5
references.pmid: 10613477
references.citation: Dis Colon Rectum. 1990 Jul;33(7):547-9
references.pmid: 2361420
references.citation: Clin Gastroenterol Hepatol. 2008 Mar;6(3):346-52
references.pmid: 18328439