Bleeding Stomal Varices: Case Series and Systematic Review of the Literature

Spier, Bret J.; Fayyad, Abdullah A.; Lucey, Michael R.; Johnson, Eric A.; Wojtowycz, Myron; Rikkers, Layton F.; Harms, Bruce A.; Reichelderfer, Mark

doi:10.1016/j.cgh.2007.12.047

Cited by 77 publications

(104 citation statements)

References 59 publications

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“…Saad et al previously reported a similar technique with external abdominal wall compression using an ultrasound transducer [6]. In the systematic review by Spier et al [7], sclerotherapy was reported to carry a risk of stomal damage. On the other hand, Minami et al and Takano et al reported successful balloonoccluded retrograde transvenous obliteration for stomal varices [8,9].…”

Section: Discussionmentioning

confidence: 98%

Stomal Varices Treated by Two Different Interventional Approaches

Yata

Ohuchi

Kodani

et al. 2017

Interventional Radiology

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We report two patients with colon cancer suffering from stomal variceal bleeding who were treated by two different interventional approaches. In case 1, a retrograde approach was applied to perform sclerotherapy of stomal varices, due to liver metastases. After access to the superficial epigastric vein as one of the efferent veins by the percutaneous approach, stomal varices were embolized using a sclerosant under compression of the efferent veins by hand, rolled gauze packs, and balloon occlusion. In case 2, two vascular plugs were placed in the two afferent veins by the antegrade transhepatic approach. Case 1 suffered from massive ascites after the procedure. No recurrent stomal variceal bleeding occurred until the patients' death in both cases. Blood flow reduction to the stoma may be sufficient for patients with a short prognosis.

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Section: Discussionmentioning

confidence: 98%

Stomal Varices Treated by Two Different Interventional Approaches

Yata

Ohuchi

Kodani

et al. 2017

Interventional Radiology

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“…The endoscopic sclerotherapy, a technique that has been demonstrated in a review of cases series, can cause mucosal ulceration, stomal retraction, stenosis, and necrosis. 1,3 The use of beta-blockers as monotherapy in secondary prophylaxis does not reduce the risk of recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the latter cases, the risk of bleeding is quadrupled, compared to those located at the esophagogastric area, with a mortality of up to 40%, 2 thus, becoming a diagnostic and therapeutic challenge. 3 The main clinical manifestation in patients with portal hypertension and ectopic varices, who are carriers of an ileal conduit, is bleeding at the stomal location, mainly at the mucocutaneous junction. 4,5 The bleeding episodes are usually intermittent and may imply vital compromise due to their recurrent nature and intensity within short periods of time.…”

Section: Introductionmentioning

confidence: 99%

Bleeding due to ectopic varices in a urinary diversion: A multidisciplinary diagnostic and therapeutic challenge

Acosta

Reyes

Menéndez

2015

CUAJ

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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.

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“…Er wordt zelfs geadviseerd bij patiënten met portale hypertensie geen enterocutane stomata aan te leggen [4]. Lokale therapie om de bloeding onder controle te krijgen, bestaat bijvoorbeeld uit lokale compressie door druk of het inbrengen van een Foley-katheter, zoals ook in onze casus eerst met succes is gedaan.…”

Section: Beschouwingunclassified

“…Foley-katheters maar ook andere conservatieve behandelingen, zoals lokale compressie, geven een recidiefkans van 74 % [5]. Tevens is sclerotherapie van de varices beschreven, maar deze kan leiden tot aanzienlijke schade van de mucosa van het stoma zelf [4]. Selectieve angiografie en embolisatie van parastomale varices is ook herhaaldelijk beschreven [6,7].…”

Section: Beschouwingunclassified

Case-report. Bloedverlies uit een Brickerse lis op basis van parastomale varices

et al. 2017

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Samenvatting Parastomale varices kunnen leiden tot levensbedreigende en moeilijk te behandelen stomabloedingen. Dit artikel betreft een casus van een fatale stomabloeding bij een patiënte met parastomale varices op basis van levercirrose. Tevens worden verschillende therapeutische mogelijkheden besproken en eerdere casus uit de literatuur aangehaald.Trefwoorden Bricker · parastomale bloeding · parastomale varices · urinedeviatie Case-report. Haemorrhage from peristomal varicesAbstract Peristomal varices can give rise to life-threatening haemorrhage that can be difficult to treat. This paper describes the case of a fatal stomal haemorrhage in a patient with peristomal varicous veins due to hepatic chirrosis. A range of therapeutical options and previous cases from the literature are being discussed.

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Bleeding Stomal Varices: Case Series and Systematic Review of the Literature

Cited by 77 publications

References 59 publications

Stomal Varices Treated by Two Different Interventional Approaches

Stomal Varices Treated by Two Different Interventional Approaches

Bleeding due to ectopic varices in a urinary diversion: A multidisciplinary diagnostic and therapeutic challenge

Case-report. Bloedverlies uit een Brickerse lis op basis van parastomale varices

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