The Role of Minimally Invasive Percutaneous Embolisation Technique in the Management of Bleeding Stomal Varices

被引：16

作者：

Kwok, Albert C. H. ^{[1
,2
]}

Wang, Frank ^{[1
,2
]}

Maher, Richard ^{[2
,3
]}

Harrington, Timothy ^{[2
,3
]}

Gananadha, Sivakumar ^{[1
,2
]}

Hugh, Thomas J. ^{[1
,2
]}

Samra, Jaswinder S. ^{[1
,2
]}

机构：

[1] Univ Sydney, Royal N Shore Hosp, Upper Gastrointestinal Surg Unit, Sydney, NSW 2006, Australia

[2] Univ Sydney, North Shore Private Hosp, Sydney, NSW 2006, Australia

[3] Univ Sydney, Royal N Shore Hosp, Dept Radiol, Sydney, NSW 2006, Australia

来源：

JOURNAL OF GASTROINTESTINAL SURGERY | 2013年 / 17卷 / 07期

关键词：

Stomal varix; Portal hypertension; Embolisation; INTRAHEPATIC PORTOSYSTEMIC SHUNT; ECTOPIC VARICES; COIL EMBOLIZATION;

D O I：

10.1007/s11605-013-2180-y

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Stomal varices can develop in patients with ostomy in the setting of portal hypertension. Bleeding from the stomal varices is uncommon, but the consequences can be disastrous. Haemorrhage control measures that have been described in the literature include pressure dressings, stomal revision, mucocutaneous disconnection, variceal suture ligation and sclerotherapy. These methods may only serve to temporise the stomal bleeding and have a high risk of recurrent bleed. While transjugular intrahepatic porto-systemic shunting has been advocated as the treatment of choice in patients with underlying liver cirrhosis, histoacryl glue or coil embolisation has been successfully employed in patients who are not suitable candidates for TIPS. Direct percutaneous embolisation of the dominant varices was performed successfully under ultrasound and fluoroscopic guidance in two patients using a combination of coils and histoacryl glue. While transjugular intrahepatic porto-systemic shunting has been advocated as the treatment of choice in patients with underlying liver cirrhosis, histoacryl glue or coil embolisation has been successfully employed in patients who are not suitable candidates for TIPS. Direct percutaneous embolisation is a safe and effective treatment for stomal varices in selected patients.

引用

页码：1327 / 1330

页数：4

共 13 条

[1] Transjugular intrahepatic porto-systemic shunt and variceal embolisation in the management of bleeding stomal varices [J].