Park Sumin, Kim Myung Sub, Hong Hyun Pyo
J Korean Soc Radiol. 2025 Jul;86(4):543-548. doi: 10.3348/jksr.2024.0082. Epub 2025 Jul 25.
Patients with portal hypertension who have undergone stoma surgery are at risk of developing stomal varices, which can occasionally lead to bleeding. Recurrent stomal bleeding can be life-threatening; however, the optimal treatment for this condition remains unestablished due to the rarity of such varices. We report a case of a 73-year-old man with liver cirrhosis and a history of abdominoperineal resection with colostomy for rectal cancer, in whom stomal variceal bleeding was successfully treated with coil embolization and sclerotherapy via a direct percutaneous approach to the afferent vein. No re-bleeding occurred within 3 months of follow-up, and no serious complications were observed. We propose that coil embolization combined with sclerotherapy via a direct percutaneous approach is a feasible and effective treatment option for bleeding stomal varices in patients with decompensated cirrhosis.
接受造口手术的门静脉高压患者有发生造口静脉曲张的风险,偶尔可导致出血。复发性造口出血可能危及生命;然而,由于这种静脉曲张罕见,针对这种情况的最佳治疗方法尚未确定。我们报告一例73岁男性患者,患有肝硬化,有直肠癌腹会阴切除并结肠造口术病史,通过直接经皮入路至输入静脉进行线圈栓塞和硬化治疗成功治疗了造口静脉曲张出血。随访3个月内未发生再出血,也未观察到严重并发症。我们认为,通过直接经皮入路进行线圈栓塞联合硬化治疗是失代偿期肝硬化患者造口静脉曲张出血的一种可行且有效的治疗选择。