Successful Coil Embolization with Sclerotherapy for Bleeding Stomal Varices Using a Direct Percutaneous Approach: A...

Area of Science:

• Gastroenterology and Hepatology
• Interventional Radiology

Background:

• Portal hypertension, a complication of liver cirrhosis, increases the risk of developing stomal varices after ostomy surgery.
• Stomal varices can lead to recurrent, potentially life-threatening bleeding, with limited established treatment options due to their rarity.

Observation:

• A 73-year-old male with liver cirrhosis and a history of abdominoperineal resection with colostomy presented with bleeding stomal varices.
• The patient underwent a novel interventional procedure.

Findings:

• Successful treatment of stomal variceal bleeding was achieved using coil embolization and sclerotherapy.
• The procedure involved a direct percutaneous approach to the afferent vein, avoiding re-bleeding within 3 months post-treatment.
• No serious complications were observed during the follow-up period.

Implications:

• This case suggests that combined coil embolization and sclerotherapy via a direct percutaneous approach is a viable and effective treatment for bleeding stomal varices.
• This minimally invasive technique may be a valuable option for patients with decompensated cirrhosis and stomal variceal bleeding.