Direct Percutaneous Embolization of Bleeding Stomal Varices

Naidu, Sailendra; Castle, Erik P.; Kriegshauser, J. Scott; Huettl, Eric A.

doi:10.1007/s00270-009-9536-4

Cited by 38 publications

(34 citation statements)

References 18 publications

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“…EIS is effective for controlling stomal variceal bleeding [94], and portosystemic surgery is effective for prevention of recurrent bleeding but also is associated with significant morbidity and mortality [95]. PTO has been used safely for acute stomal variceal bleeding [92, 96, 97]; however, recurrent bleeding is frequent. TIPS is an effective therapy for bleeding stomal varices [98–100] but may result in a higher mortality of patients with severe decompensated liver function because of encephalopathy, rather than the stomal variceal bleeding itself [96].…”

Section: Stomal Varicesmentioning

confidence: 99%

Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension

Sato

Akaike

Toyota

et al. 2011

International Journal of Hepatology

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Bleeding from ectopic varices, which is rare in patients with portal hypertension, is generally massive and life-threatening. Forty-three patients were hospitalized in our ward for gastrointestinal bleeding from ectopic varices. The frequency of ectopic varices was 43/1218 (3.5%) among portal hypertensive patients in our ward. The locations of the ectopic varices were rectal in thirty-two, duodenal in three, intestinal in two, vesical in three, stomal in one, and colonic in two patients. Endoscopic or interventional radiologic treatment was performed successfully for ectopic varices. Hemorrhage from ectopic varices should be kept in mind in patients with portal hypertension presenting with lower gastrointestinal bleeding.

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Section: Stomal Varicesmentioning

confidence: 99%

Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension

Sato

Akaike

Toyota

et al. 2011

International Journal of Hepatology

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“…In patients with a poor condition, interventional radiologic techniques, such as transjugular intrahepatic portosystemic shunts (TIPS), percutaneous transhepatic obliteration (PTO) and balloon-occluded retrograde transvenous obliteration (B-RTO) have been used successfully for stomal variceal bleeding as a non-surgical option. PTO for stomal variceal bleeding also has been performed successfully [7][8][9][10][11]. The potential complications of PTO include bile leakage, bleeding, liver trauma, and portal vein thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Stomal Variceal Bleeding with Percutaneous Injection Sclerotherapy

Sato¹

2015

Arch Clin Gastroenterol

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Bleeding from ectopic varices is often massive and fatal with portal hypertension, and stomal varices can occur in patients with stoma. We aimed to treat a hepatitis B surface antigen positive 69 year-old male with liver cirrhosis associated hepatocellular carcinoma with bleeding stomal varices using percutaneous injection sclerotherapy. Percutaneous injection sclerotherapy was performed under fluoroscopy using 5% ethanolamine oleate with iopamidol (EOI) with a 25 gauge disposable injection needle; 5ml of 5% EOI were injected gradually. Injection sclerotherapy controlled acute bleeding in this patient without serious complication. The patient experienced no further episodes of bleeding during the 8 months following treatment with percutaneous injection sclerotherapy. In conclusion, percutaneous injection sclerotherapy remains an option for the treatment of patients with bleeding stomal varices.

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“…Naidu et al [10] and Arulraj et al [11] embolized afferent veins with metallic coils after inserting the catheter to the vessel through the punctured stomal varices. Kwok et al [12] used a combination of metallic coils and histoacryl glue with the same approach.…”

Section: Discussionmentioning

confidence: 99%

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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Direct Percutaneous Embolization of Bleeding Stomal Varices

Cited by 38 publications

References 18 publications

Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension

Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension

Successful Treatment of Stomal Variceal Bleeding with Percutaneous Injection Sclerotherapy

Stomal Varices Treated by Two Different Interventional Approaches

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