Chong Vui Heng, Tan Kim Khee, Sharif Faisal
Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam, BA.
Surg Laparosc Endosc Percutan Tech. 2008 Oct;18(5):520-2. doi: 10.1097/SLE.0b013e31817739d3.
Parastomal varices are known complication of stoma creation in patients with portal hypertension. Similar to esophageal and gastric varices, bleeding can occur and can lead to hepatic decompensation and even death. Diagnosis of parastomal bleeding may be delayed if not suspected. Established treatment for bleeding parastomal varices includes transjugular intrahepatic porto-systemic shunt creation and surgery. We report a case of a patient with carcinoma of the cervix that was complicated by a rectal stricture postradiotherapy requiring a diversion colostomy. She also had end stage chronic liver disease secondary to chronic hepatitis C infection. She presented with 3 episodes of parastomal varices bleeding that was not initially suspected and was successfully treated with 1 session of percutaneous N-butyl-2-cyanoacrylate (Histoacryl) glue injection.
造口旁静脉曲张是门静脉高压患者造口术后已知的并发症。与食管和胃静脉曲张相似，可发生出血，并可导致肝失代偿甚至死亡。如果未被怀疑，造口旁出血的诊断可能会延迟。治疗出血性造口旁静脉曲张的既定方法包括经颈静脉肝内门体分流术和手术。我们报告一例宫颈癌患者，该患者放疗后并发直肠狭窄，需要行转流结肠造口术。她还患有慢性丙型肝炎感染继发的终末期慢性肝病。她出现了3次造口旁静脉曲张出血，最初未被怀疑，经1次经皮注射N-丁基-2-氰基丙烯酸酯（组织黏合剂）成功治疗。
