Partial splenic embolization improved stomal varices in patient with decompensated liver cirrhosis: a case report.
Clin J Gastroenterol
; 17(1): 100-105, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37878139
ABSTRACT
A 63-year-old man with decompensated liver cirrhosis was admitted for treatment of stomal hemorrhage. Eighteen months earlier, he was diagnosed with rectal and sigmoid colon cancer with multiple lymph node metastases, and he underwent colostomy surgery and postoperative chemotherapy. Sixteen months after the surgery, his stoma began to bleed repeatedly, and he required frequent blood transfusions. A contrast-enhanced computed tomography revealed ectopic varices around the stoma. We considered surgical or endoscopic treatment; however, these approaches would have been technically difficult in this patient. The patient was treated with partial splenic embolization to improve thrombocytopenia and portal hypertension. After two-stage partial splenic embolization, the platelet counts increased, and the concentration of the liver fibrosis marker, Mac-2 binding protein, decreased. In addition, blood flow in the stomal varices decreased, with no recurrence of bleeding. This is a case of recurrent hemorrhage from stomal varices that was successfully treated with partial splenic embolization in a patient with liver cirrhosis. There are no guidelines for hemorrhage from ectopic varices. PSE may present potential utility as a treatment for ectopic variceal bleeding, such as stomal varices.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Varizes
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Varizes Esofágicas e Gástricas
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Embolização Terapêutica
Limite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin J Gastroenterol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Japão