Document Detail


Treatment of bleeding stomal varices by balloon-occluded retrograde transvenous obliteration.
MedLine Citation:
PMID:  17323000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although stomal varices are a rare complication, bleeding stomal varices often need to be treated owing to symptoms of hypovolemic shock, recurrence of stomal bleeding, or deterioration in the quality of life. Various treatment strategies for the management of bleeding stomal varices have thus far been reported. We report the case of a 60-year-old woman with refractory recurrent bleeding from varices in a sigmoid stoma, along with nonalcoholic steatohepatitis and marked splenomegaly. A physical examination revealed that the skin was discolored and bluish around the circumference of the sigmoid stoma. The venous phase of a celiac arteriogram revealed an afferent vein from the splenic vein and another from the inferior mesenteric vein, and veins draining into the left superficial epigastric vein. A balloon-occluded retrograde transvenous obliteration (BRTO) procedure was performed. The skin around the stoma, initially discolored bluish, improved markedly. After 10 months of follow-up, the patient has remained well without further episodes of stomal bleeding. To our knowledge, this is the first case of recurrent hemorrhage from stomal varices that was successfully treated by BRTO in a patient with portal hypertension.
Authors:
Shigeki Minami; Kazuya Okada; Mitsutoshi Matsuo; Yukio Kamohara; Ichiro Sakamoto; Takashi Kanematsu
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-02-16
Journal Detail:
Title:  Journal of gastroenterology     Volume:  42     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-02-26     Completed Date:  2007-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  91-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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MeSH Terms
Descriptor/Qualifier:
Balloon Occlusion* / methods
Colon, Sigmoid / surgery
Colostomy*
Esophageal and Gastric Varices / radiography,  therapy*
Female
Gastrointestinal Hemorrhage / therapy*
Humans
Middle Aged
Postoperative Complications / therapy*
Recurrence
Tomography, X-Ray Computed

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