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

Ranjan Kumar Patel; Karamvir Chandel; Taraprasad Tripathy; Ashok Choudhury; Amar Mukund

doi:10.1016/j.jceh.2021.09.005

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

J Clin Exp Hepatol. 2022 Mar-Apr;12(2):649-653. doi: 10.1016/j.jceh.2021.09.005. Epub 2021 Sep 10.

Authors

Ranjan Kumar Patel¹, Karamvir Chandel¹, Taraprasad Tripathy¹, Ashok Choudhury², Amar Mukund¹

Affiliations

¹ Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
² Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.

Abstract

Although stomal and parastomal varices are uncommon causes of variceal bleeding, the mortality rate might be as high as 40%. Timely intervention is essential for the management of these ectopic bleeding varices. Due to the rarity of such varices, no standard treatment guideline is available. We present three cases of bleeding stomal varices managed with an endovascular approach, one through percutaneous transhepatic and the other two through transjugular intrahepatic portosystemic shunt approach.

Keywords: APR, Abdominoperineal resection; BRTO, Balloon-occluded retrograde transvenous obliteration of stomal varices; CECT, Contrast-enhanced computed tomography; CTP score, Child-Turcotte-Pugh score; GI, Gastrointestinal; IMV, Inferior mesenteric vein; MELD, Model for end-stage liver disease; NASH, Nonalcoholic steatohepatitis; Na, Sodium; SMV, Superior mesenteric vein; SVB, Stomal variceal bleeding; TIPS, Transjugular intrahepatic portosystemic shunt; UGIE, Upper gastrointestinal endoscopy; USG, Ultrasonography; glue; stomal varices; transjugular intrahepatic portosystemic shunt (TIPS).

Publication types

Case Reports