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Successful Management of Neobladder Variceal Bleeding
Dinesh Atwal1, Kshitij Chatterjee2, Scott Osborne3
1Department of Internal Medicine, Residency Program: Slot 634, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA.
Cardiovascular and Interventional Radiology
|June 5, 2016
Summary
Variceal bleeding in a neobladder is rare. This case report details successful management using transjugular intrahepatic portosystemic shunt (TIPS) and embolization for a patient with cirrhosis and portal hypertension.
Area of Science:
- Urology
- Gastroenterology
- Interventional Radiology
Background:
- Neobladders can develop hematuria from various causes like tumors, stones, and fistulas.
- Variceal bleeding within a neobladder is an exceptionally rare complication, with limited documented cases.
- Cirrhosis and portal hypertension increase the risk of variceal formation and bleeding.
Observation:
- A patient with cirrhosis and portal hypertension presented with significant hematuria.
- The patient had undergone creation of an ileocolic orthotopic neobladder.
- Computed tomographic angiography revealed dilated varices surrounding the neobladder.
Findings:
- The varices identified around the neobladder were the source of the hematuria.
- Successful embolization of the dilated varices was performed.
- The patient's condition was ultimately managed with a combination of transjugular intrahepatic portosystemic shunt (TIPS) and embolization.
Implications:
- This case highlights a novel and effective treatment strategy for rare variceal bleeding in neobladders.
- The combined approach of TIPS and embolization offers a viable solution for managing this challenging complication.
- Further research may explore the long-term efficacy and safety of this combined treatment in similar cases.
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