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Parastomal Variceal Bleeding Attributed to Obstructive Pathology Successfully Treated by Percutaneous Variceal
Yutaka Tomizawa1, Atsushi Sakuraba1, Joel Pekow1
1Department of Medicine, Section of Gastroenterology, Hepatology, and Nutrition, The University of Chicago, Chicago, IL.
ACG Case Reports Journal
|July 10, 2015
Summary
Parastomal variceal bleeding, a rare gastrointestinal bleed in patients with portal hypertension and stomas, requires consideration. Percutaneous embolization offers an alternative when transjugular intrahepatic portosystemic shunt (TIPS) is not feasible.
Area of Science:
- Gastroenterology
- Interventional Radiology
Background:
- Parastomal variceal bleeding is a rare but serious complication in patients with portal hypertension and surgical stomas.
- Standard management is not well-established, but transjugular intrahepatic portosystemic shunt (TIPS) is a recommended treatment for portal hypertension decompression.
Observation:
- A case of parastomal variceal bleeding was successfully treated.
- The patient had underlying portal hypertension and a surgical stoma.
Findings:
- Percutaneous parastomal variceal embolization was utilized as an emerging alternative therapy.
- This interventional technique provided a treatment option when TIPS was not indicated or feasible.
Implications:
- Percutaneous embolization represents a viable and emerging therapeutic option for parastomal variceal bleeding.
- This approach may be crucial for managing patients with portal hypertension and stomas who are unsuitable for TIPS.
- Further research into endovascular techniques for parastomal variceal bleeding is warranted.
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