Adson M A, Fulton R E
Arch Surg. 1977 Apr;112(4):501-4. doi: 10.1001/archsurg.1977.01370040153023.
Patients who have chronic ulcerative colitis coexisting with liver disease and portal hypertension may suffer hemorrhagic parastomal varices after proctocolectomy and ileostomy. Large portal systemic collateral vessels between the superior mesenteric venous tributaries and the abdominal wall can be demonstrated by portal venography. Hemorrhage occurs from the mucocutaneous junction, a vulnerable point in this collateral circuit. Management by major and minor stomal revisions has been unsuccessful. Three patients who have bled from stomal and from esophagogastric varices were treated with portasystemic shunts. None of the three has had recurrent bleeding or postshunt encephalopathy during the 19 to 27 months after these operations.
患有慢性溃疡性结肠炎并伴有肝脏疾病和门静脉高压的患者，在直肠结肠切除术后和回肠造口术后可能会出现出血性造口旁静脉曲张。肠系膜上静脉分支与腹壁之间的大的门体侧支血管可通过门静脉造影显示。出血发生在黏膜皮肤交界处，这是该侧支循环中的一个薄弱点。通过大小造口修复进行治疗均未成功。三名因造口和食管胃静脉曲张出血的患者接受了门体分流术治疗。在这些手术后的19至27个月期间，这三名患者均未出现复发性出血或分流术后脑病。
