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Updated: May 30, 2026
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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Recurrent bleeding of parastomal varices: case report
Adem Karataş1, Ozan Gültekin Küçük, Erman Aytaç
1Department of General Surgery, Cerrahpaşa Medical Faculty, İstanbul University, İstanbul, Turkey.
Summary
Recurrent bleeding from parastomal varices, a rare complication of portal hypertension, was successfully treated. This case involved a patient with autoimmune hepatitis and rectal cancer, highlighting a novel endoscopic therapy.
Area of Science:
- Gastroenterology and Hepatology
- Interventional Endoscopy
- Hepatobiliary Disease Management
Background:
- Parastomal varices represent an uncommon but potentially severe complication of portal hypertension.
- Chronic liver disease, particularly autoimmune hepatitis, can predispose individuals to portal hypertension.
- Previous abdominoperineal resection for rectal cancer can alter abdominal anatomy, potentially influencing variceal development.
Observation:
- A patient with a history of autoimmune hepatitis and rectal cancer experienced recurrent bleeding from parastomal varices.
- Four distinct episodes of parastomal variceal hemorrhage occurred within a single month.
- The bleeding episodes presented a significant management challenge due to their recurrence and location.
Findings:
- A combined endoscopic approach utilizing polidocanol and cyanoacrylate glue was employed for treatment.
- This dual-agent endoscopic therapy effectively achieved hemostasis and resolved the recurrent bleeding.
- The successful management demonstrates the efficacy of this specific interventional technique.
Implications:
- This case highlights a successful therapeutic strategy for managing rare parastomal variceal bleeding.
- Combined polidocanol and cyanoacrylate glue injection offers a viable endoscopic solution for refractory cases.
- Further research into endoscopic management of parastomal varices in patients with complex abdominal histories is warranted.
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