Chronic stomal variceal bleeding after colonic surgery in patients with portal hypertension: efficacy of beta-blocking agents?

In patients with portal hypertension, ileostomy or colostomy carries the risk of the development of stomal varices at the site of the mucocutaneous junction of a stoma. Such varices are often the source of difficult-to-treat recurrent or chronic bleeding. In this setting, transjugular intrahepatic portosystemic shunt insertion and embolisation is considered the best therapeutic approach in spite of relatively high mortality and morbidity rates. We report the cases of three consecutive patients with portal hypertension of various causes and chronic stomal variceal bleeding in whom beta-blocking therapy resulted in the drying up of bleeding and the prevention of its recurrence for periods of time ranging between 2 and 42 months.