Hemorrhage from ileal varices: a delayed complication after total proctocolectomy in a patient with ulcerative colitis and cirrhosis

A 60-year-old woman presented with recurrent ileostomal hemorrhage 29 years after proctocolectomy for ulcerative colitis. Ileal varices were demonstrated by selective mesenteric angiography, and a portasystemic shunt was performed with control of the bleeding. Stomal varices typically present with repeated episodes of bleeding at and proximal to the mucocutaneous junction of the ileal stoma and attempts at local corrective measures generally meet with only temporary success. A portasystemic shunt to diminish portal hypertension in this situation is currently the most widely accepted therapy for this entity.