Case Series Regarding Parastomal Variceal Bleeding: Presentation and Management

Romano, John; Welden, Charles V.; Orr, Jordan; McGuire, Brendan M.; Shoreibah, Mohamed

doi:10.5604/01.3001.0012.7934

Cited by 10 publications

(4 citation statements)

References 50 publications

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“…Glue more effectively obliterates the tiny and distal venous channels, in contrast to more proximal embolization by coils. 5,7,8 Proper patient selection is critical before TIPS since TIPS worsens the existing liver function and may result in hepatic decompensation. Every patient of SVB may not be a candidate for TIPS due to baseline liver function or other associated co-morbidities.…”

Section: Discussionmentioning

confidence: 99%

“…5 Local sclerotherapy has also been used to treat SVB with mixed outcomes; however, sclerosant can induce stomal damage. 4,8 Balloon occluded retrograde transvenous obliteration of stomal varices (BRTO) and retrograde venous access through the left superficial epigastric vein have also been employed. 11 Because of the increased morbidity and mortality, surgical portosystemic shunts are rarely recommended.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…However, many of these patients have co-morbidities that may prohibit liver transplantation and the construction of surgical shunts. 4,8…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

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Bleeding Stomal Varices and Their Interventional Management- A Series of Three Cases

Patel

Chandel

Tripathy

et al. 2022

Journal of Clinical and Experimental Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

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Bleeding Stomal Varices and Their Interventional Management- A Series of Three Cases

Patel

Chandel

Tripathy

et al. 2022

Journal of Clinical and Experimental Hepatology

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“…In a literature review of 163 patients with stomal variceal bleeding, [7,160] 57 patients were treated with TIPS and 12 with surgical portosystemic shunt, 35 patients with endovascular embolization and RTO, 18 with surgical revision, and the rest with a variety of local therapies, including banding and sclerotherapy. With increased rates of recurrent bleeding with TIPS alone, a combination of these procedures has been found to associate with better results, emphasizing that TIPS should be associated with concomitant embolization or a combination of aforementioned procedures.…”

Section: Stomal Varicesmentioning

confidence: 99%

AASLD Practice Guidance on the use of TIPS, variceal embolization, and retrograde transvenous obliteration in the management of variceal hemorrhage

et al. 2023

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This is a comprehensive guidance on the use of interventional radiology endovascular techniques in the management of variceal hemorrhage from the American Association for the Study of Liver Diseases (AASLD). This guidance document is complementary to the AASLD "Risk Stratification and Management of Portal Hypertension and Varices in Cirrhosis" guidance [1] and addresses the recent advancements in these invasive procedures. Although the use of TIPS dates back to the 1980s, several new technical refinements in TIPS stents have occurred in the last few years. The other major addition to the management of gastric variceal hemorrhage in North America has been the introduction of retrograde transvenous obliteration (RTO) in its different forms. The present document aims to equip care providers with an in-depth understanding of the use of TIPS and/or variceal embolization/obliteration in the management of variceal hemorrhage. The goal is to facilitate multidisciplinary discussions between hepatologists, gastroenterologists, interventional radiologists, and surgeons in the

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