Document Detail


Liver metastases, a rare cause of portal hypertension and stoma bleeding. Brief review of literature.
MedLine Citation:
PMID:  22387413     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Portal hypertension is an unusual complication of liver metastases, which is frequently occurring in malignant disease. Portal hypertension may cause oesophageal varices and also stoma varices (colostomy and ileostomy). Oesophageal varices and bleeding from these varices have been frequently reported in literature. Stomal varices have also been reported in literature mostly associated with liver cirrhosis. These stomal varices lead to the massive bleeding causing morbidity and mortality. Portal hypertension is a pathological increase in portal pressure gradient (the difference between pressure in the portal and inferior vena cava veins). It is either due to an increase in portal blood flow or an increase in vascular resistance or combination of both. In liver cirrhosis, the primary factor leading to portal hypertension is increase in portal blood flow resistance and later on development of increased portal blood flow. It has been postulated that in liver metastasis the increase in portal flow resistance occurs at any site within portal venous system as a consequence of mechanical architectural disturbance. PRESENTATION OF CASE: We report a case of a 64 year old gentleman who developed portal hypertension due to secondary metastases from colorectal cancer. He subsequently developed bleeding varices in his end colostomy. DISCUSSION: We believe that the combination of extensive metastases and chemotherapy induced portal hypertension in our patient. CONCLUSION: Our case and other literature review highlight that the recurrent bleeding stoma associated with colorectal cancer should be investigated for portal hypertension.
Authors:
E Theophilidou; N Waraich; T Raza; P K Agarwal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-1
Journal Detail:
Title:  International journal of surgery case reports     Volume:  3     ISSN:  2210-2612     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-3-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101529872     Medline TA:  Int J Surg Case Rep     Country:  -    
Other Details:
Languages:  ENG     Pagination:  173-176     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Affiliation:
46 The Quays, Castle Quay Close, Nottingham NG7 1HR, United Kingdom.
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