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Variceal bleeding from an ileostomy stoma.

M M Wang, W McGrew, G D Dunn

    Southern Medical Journal
    |June 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Portal hypertension can cause bleeding from ileal varices in patients who have had a total colectomy. Diagnosis involves mesenteric arteriography and stoma inspection, with management options including local control or portal vein decompression.

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    Area of Science:

    • Gastroenterology
    • Vascular Surgery

    Background:

    • Portal hypertension, often caused by cirrhosis, typically leads to esophageal or gastric variceal bleeding.
    • In patients who have undergone a total colectomy, alternative sites of variceal bleeding must be considered.

    Observation:

    • Ileal varices, located in the small intestine, can present as a bleeding source in the context of portal hypertension.
    • Diagnosis necessitates a detailed examination of the venous phase of mesenteric arteriograms to identify ileal varices.
    • Careful inspection of the mucocutaneous region of the ileal stoma is crucial for detecting active venous bleeding.

    Findings:

    • Mesenteric arteriography is key for visualizing ileal varices.
    • Direct observation of the ileal stoma is essential for identifying bleeding points.

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    Implications:

    • Early and accurate diagnosis of ileal varices is vital for effective patient management.
    • Treatment strategies for bleeding ileal varices include both localized interventions and systemic approaches like portal vein decompression.