Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Case Reports
A case report of stomal varices treated with variceal obliteration
Kentaro KOKUBOTakuya YAMADAMasaki KIMURANaomasa YOSHIDATakafumi SEKINOHirofumi TAKEMURA
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2009 Volume 70 Issue 9 Pages 2743-2746

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Abstract
A 73-year-old man, with a history of an abdominoperineal resection of the rectum and colostomy for rectal cancer in 1996, as well as a middle bile duct resection for bile duct cancer in 2007, was found to have bleeding stomal varices 2 months after the bile duct resection. He was admitted due to the presence of repeat bleeding episodes which occurred despite the use of pressure and ligation. The patient's abdomenal was distended and was in shock. Enhanced abdominal CT showed pooling of contrast medium around the colostomy stoma and ascites. The stomal varices involved an afferent from the inferior mesenteric vein and drained into the left inferior epigastric vein. The stomal varices were treated with an inferior mesenteric vein ligation and left inferior epigastric vein obliteration using N-butyl-2-cyanoacrylate (Histoacryl®) under local anesthesia. The patient's postoperative course was uneventful ; his bleeding stomal varices have not recurred. Variceal obliteration is effective in controlling bleeding stomal varices.
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© 2009 Japan Surgical Association
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