Journal
INTERNAL MEDICINE JOURNAL
Volume 45, Issue 2, Pages 214-217Publisher
WILEY-BLACKWELL
DOI: 10.1111/imj.12662
Keywords
ectopic varices; stomal varices; variceal haemorrhage; sclerotherapy; transjugular intrahepatic portosystemic shunt
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Stomal variceal bleeding is a rare but life-threatening complication of cirrhosis. As it is an uncommon condition, there is little evidence on the optimum treatment. We report a case of parastomal variceal bleeding in a cirrhotic and haemodynamically unstable patient. The bleeding had failed to respond to local therapy and was not amenable to transjugular intrahepatic portosystemic shunting. The varix was successfully treated under radiological guidance embolisation in conjunction with Fibrovein (STD Pharmaceuticals, UK) sclerosis. We propose that Fibrovein sclerosis through angiography should be considered as an initial treatment option in patients with parastomal variceal bleeding who are not candidates for transjugular intrahepatic portosystemic shunting.
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