Percutaneous transhepatic embolization as treatment for bleeding ileostomy varices

Abstract

We report two patients with bleeding stomal varices following total colectomy and ileostomy. The varices were demonstrated by superior mesenteric angiography and percutaneous transhepatic mesenteric venography; dilated ileal veins drained via the stomal varices into abdominal wall veins. Bleeding from the stomal varices was treated by transhepatic embolization. The first patient required three transhepatic embolizations after recurrent bleeding due to recanalization of the embolized ileal vein and the development of collaterals from the adjacent ileal veins over a one-year period. The second patient died of respiratory failure 1 week after embolization. Neither patient developed mesenteric or stomal ischemia.