Goldstein W Z, Edoga J, Crystal R
Dis Colon Rectum. 1980 Mar;23(2):86-90. doi: 10.1007/BF02587599.
Colostomy and ileostomy stomal hemorrhage is a rare and potentially fatal complication of portal hypertension. We describe two patients with colostomy stomal hemorrhage who had both undergone abdominoperineal resection for carcinoma of the rectosigmoid colon. Patient 1, in the absence of metastatic disease with minimal to moderate functional hepatic impairment, undersent a mesocaval interposition graft shunt and had no recurrence of stomal hemorrhage during the four-month postoperative period. Patient 2, in the presence of metastatic disease to the lungs and liver, was not shunted and died of hepatic and renal failure. Angiography, in particular splenoportography, is extremely helpful in establishing the diagnosis of portal hypertension and planning appropriate operative procedure. We reviewed the literature on ileostomy and colostomy hemorrhage in the presence of portal hypertension and conclude that control of major stomal hemorrhage by local measures is often ineffective and that portasystemic shunts may significantly improve long-term prognosis.
结肠造口术和回肠造口术的造口出血是门静脉高压症一种罕见且可能致命的并发症。我们描述了两名结肠造口出血患者，他们均因直肠乙状结肠癌接受了腹会阴联合切除术。患者1没有转移性疾病，肝功能损害轻微至中度，接受了肠系膜上腔静脉间置移植分流术，术后四个月造口未再出血。患者2有肺和肝转移，未行分流术，死于肝肾功能衰竭。血管造影，尤其是脾门静脉造影，对于门静脉高压症的诊断和合适手术方案的制定非常有帮助。我们回顾了门静脉高压症患者回肠造口和结肠造口出血的相关文献，得出结论：通过局部措施控制主要造口出血往往无效，而门体分流术可能显著改善长期预后。
