INTRODUCTION: 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. METHODS AND 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. CONCLUSION: Direct percutaneous embolisation is a safe and effective treatment for stomal varices in selected patients.
INTRODUCTION: 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. METHODS AND 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. CONCLUSION: Direct percutaneous embolisation is a safe and effective treatment for stomal varices in selected patients.
Authors: K Kishimoto; A Hara; T Arita; K Tsukamoto; N Matsui; T Kaneyuki; N Matsunaga Journal: Cardiovasc Intervent Radiol Date: 1999 Nov-Dec Impact factor: 2.740
Authors: Bassam Alkari; Nabeel M Shaath; Yesar El-Dhuwaib; Ali Aboutwerat; Thomas W Warnes; Nicholas Chalmers; Basil J Ammori Journal: Int J Colorectal Dis Date: 2005-01-14 Impact factor: 2.571
Authors: V Vidal; L Joly; P Perreault; L Bouchard; M Lafortune; G Pomier-Layrargues Journal: Cardiovasc Intervent Radiol Date: 2006 Mar-Apr Impact factor: 2.740
Authors: William Ryan; Farouk Dako; Gary Cohen; David Pryluck; Joseph Panaro; Emily Cuthbertson; Dmitry Niman Journal: Case Rep Radiol Date: 2018-08-08