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Bleeding ileal conduit stomal varices: diagnosis and management using transjugular transhepatic angiography and
D B Lashley1, R R Saxon, E F Fuchs
1Division of Urology and Dotter Interventional Institute, Oregon Health Sciences University, Portland 97201, USA.
Abstract:
An uncommon complication of ileal conduit urinary diversion is bleeding varices at the stoma site. Variceal formation is a complication of portal hypertension, which is most commonly due to intrinsic liver disease. Problematic recurrent bleeding is usually managed locally or by portosystemic shunt. We report a case of recurrent, massive ileal conduit variceal hemorrhage in a patient without a significantly elevated portosystemic gradient. Therefore, this patient was not a candidate for a shunt procedure. Using a transjugular transhepatic approach to the portal vein, the varices were embolized to stasis without any complications. The patient has subsequently experienced no further bleeding episodes.
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