Transcatheter embolization for stomal varices: A report of three patients

Abstract

Stomal varices are rare and ectopic varices defined as dilated portosystemic collateral veins located in sites other than the gastro-esophageal region. These sometimes cause recurrent bleedings and can be life-threatening. Optimal treatments have yet to be established. We report 3 cases of repetitive bleeding stomal varices in which resolution of bleeding was obtained over the medium term with minimally invasive approaches including balloon-occluded retrograde transvenous obliteration and variceal embolization by ultrasound-guided direct puncture. Rebleeding did not occur in any patients within 2-15 months of follow-up. Serious complications over Clavien-Dindo grade I were not found.

Percutaneous Transhepatic Obliteration for Treating Stomal Variceal Bleeding Using a Microballoon Catheter with Systemic Drainage Vein Compression

“…Nonetheless, if bleeding continues, it can lead to serious morbidity, including repeated hospitalizations and blood transfusions [3]. Strategies for managing stomal variceal bleeding include lo-cal compression, balloon-occluded retrograde transvenous obliteration (B-RTO), embolization by direct puncture [4], percutaneous transhepatic obliteration (PTO), transjugular intrahepatic portosystemic shunting (TIPS), or stomal revision and liver transplantation [5]. Here, we report a case of successful PTO for stomal variceal bleeding using a microballoon catheter with systemic drainage vein compression from the body surface.…”