Enterostomal varices secondary to portal hypertension: progression of disease in conservatively managed cases.

A follow-up of patients with portal hypertension who were bleeding from enterostomal varices in ileostomies or colostomies demonstrated the progression of disease and poor prognosis. Repeated episodes of hemorrhage became more frequent, liver function deteriorated, and death from hepatic failure finally occurred. The hemorrhagic episodes seemed to contribute to the deterioration of the patients' conditions. Portasystemic shunting to eliminate enterostomal bleeding should be considered for the patient who is an acceptable operative risk. If major surgery is contraindicated, local hemostatic measures offer, temporarily, palliative alleviation of bleeding, but the ultimate prognosis is grave.