Bleeding due to ectopic varices in a urinary diversion: A multidisciplinary diagnostic and therapeutic challenge

Abstract

The ectopic varices in patients with portal hypertension are those that occur at any level of the gastrointestinal (GI) tract, regardless of the varices that occur at the esophageal level. These ectopic varices account for 2-5% of the causes of GI bleeding varices. The risk of bleeding is quadrupled compared to the esophagogastric area, with a mortality of up to 40%. The transjugular intrahepatic portosystemic shunt, should be considered in cases secondary to recurrent bleeding varices.We present a case report of an urological emergency of bleeding in a urinary diversion secondary to ectopic varices successfully treated through the placement of transjugular intrahepatic portosystemic shunt. The condition described here is rare, but important, as it can be a life-threatening complication of portal hypertension. This kind of complication should be known by urologic surgeons managing patients with urinary diversions.

Successful embolization of subcutaneous mesenteric varices within an ileal conduit in a patient with liver cirrhosis

“…Bleeding ectopic varices as a result of portal hypertension is a rare cause of hematuria in patients with urinary diversion using an intestinal segment. 1 When hemorrhage occurs, it can become a severe problem and has a mortality rate of 3%. 2 , 3 Importantly, a previous study found that ileal varices were present in 18% of patients with liver cirrhosis.…”