Treatment of refractory stomal variceal haemorrhage with embolisation and sclerosis

Stomal variceal bleeding is a rare but life-threatening complication of cirrhosis. As it is an uncommon condition, there is little evidence on the optimum treatment. We report a case of parastomal variceal bleeding in a cirrhotic and haemodynamically unstable patient. The bleeding had failed to respond to local therapy and was not amenable to transjugular intrahepatic portosystemic shunting. The varix was successfully treated under radiological guidance embolisation in conjunction with Fibrovein (STD Pharmaceuticals, UK) sclerosis. We propose that Fibrovein sclerosis through angiography should be considered as an initial treatment option in patients with parastomal variceal bleeding who are not candidates for transjugular intrahepatic portosystemic shunting.