Successful Management of Neobladder Variceal Bleeding

Abstract

Hematuria from a neobladder can occur due to a variety of pathologies including tumors, stones, and fistulas. Variceal bleeding in a neobladder is a very rare condition with only one case reported in literature. We present a case of a patient with cirrhosis and portal hypertension and an ileocolic orthotopic neobladder presenting with hematuria. Computed tomographic angiography showed dilated varices around the neobladder which were successfully embolized. To the best of our knowledge, this is the first report case of variceal bleeding in a neobladder successfully managed with the combination of TIPS (transjugular intrahepatic portosystemic shunt) procedure and embolization.

Muscle-Invasive Bladder Cancer in Patients with Liver Cirrhosis: A Review of Pertinent Considerations

“…Of these cases, embolization and sclerotherapy were sufficient to prevent recurrence of variceal bleeding, while ligation alone was associated with recurrence of bleeding [108,110]. Six case reports described the use of TIPS to reduce portal hypertension and did not report any recurrence of bleeding, though follow up was limited [114,116,120,122,124,127]. Finally, four case reports described variceal bleeding being treated with revision of the ileal conduit, with only two of these cases reporting no recurrence of variceal bleeding [107,109,111,115].…”