Ligating the varicose vein trunk for colostomy variceal hemorrhage: a case report

Abstract

Background: Among the complications related to colostomy, variceal hemorrhage caused by cirrhosis is a rare case. The occurrence of peristome variceal hemorrhage should be rapid and effective treatment, otherwise it will result in hemorrhagic shock, repeated stoma bleeding, systemic organs deterioration and other adverse events. Case presentation: In this case of liver cirrhosis, Stoma varices and repeated bleeding due to decompensated cirrhosis was performed by local compression and suture therapy but failed with rebleeding. Being combined with abdominal enhanced CT images，Stoma varices are derived from the branch of inferior mesenteric vein, whose above trunk is located and highly ligated and vein balls are stripped. Meanwhile, the Stoma below abdominal wall varicose veins is sutured by intracutaneous way, which could achieve satisfactory hemostasis in intra-operation. Abdominal enhanced CT images prompted that peristome varicose veins are disappeared. The skin around the stoma is flat and the mucosa is ruddy when changing the bag in post-operation. Conclusion: The report that our team reduced the risk of peristomal variceal bleeding by blocking the main variceal vein through a small incision under local anesthesia may open up another treatment strategy for such patients.