Abstract
A 66-year-old male patient with liver cirrhosis because of alcohol intake underwent a Hartmann’s procedure for rectal cancer. Four months later, bleeding from the sigmoid stoma occurred and persisted for 2 months. A colonoscopic examination revealed bleeding from stomal varices. Three-dimensional computed tomography (CT) imaging demonstrated the inferior mesenteric vein and left superficial epigastric vein as the feeding and drainage vessels, respectively. Balloon-occluded retrograde transvenous obliteration (B-RTO) through the left epigastric vein was performed using a microballoon catheter inserted from the right femoral vein according to the Seldinger method. A CT examination performed 2 days after the B-RTO procedure revealed that the blood flow had disappeared, with thrombosis formation in both the stomal varices and the feeding vein. No recurrent bleeding from the stoma occurred. B-RTO using a microballoon catheter is useful as a therapeutic procedure for stomal varices to prevent bleeding, since the procedure can be performed with minimal invasion using the Seldinger method.
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Satoshi Mochida has received research grants, speaking fees or honoraria from Ajinomoto Pharmaceuticals Co., Chugai Pharmaceutical Co., Bristol Myers Squibb, Eisai Co., Mitsubishi Tanabe Pharma Co., MSD K.K., Otsuka Pharmaceutical Co. SRL Inc., Takeda Pharmaceutical Co., Daiichi Sankyo Co., Japan Blood Products Organization, and Toray Medical Co.
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All procedures followed were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Informed consent was obtained from the patient in the report.
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Takano, M., Imai, Y., Nakazawa, M. et al. A case of liver cirrhosis with bleeding from stomal varices successfully treated using balloon-occluded retrograde transvenous obliteration . Clin J Gastroenterol 9, 145–149 (2016). https://doi.org/10.1007/s12328-016-0644-9
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DOI: https://doi.org/10.1007/s12328-016-0644-9