Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report

Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report Publisher

Yazdi NA¹ ; Aletaha N² ; Mehrabinejad MM^{1, 3} ; Dehnavi AZ^{1, 3} ; Yazdi HR¹

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1. Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center(ADIR), Tehran University of Medical Sciences, School of Medicine, Imam Khomeini Hospital, Tehran, Iran
2. Department of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran
3. Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Gastroenterology and Hepatology from Bed to Bench Published:2020

Abstract

Patients with a stoma have 5% chance of developing parastomal varices, which tend to repetitive massive and life-threatening hemorrhages. Treatment of choice in parastomal varices have not been established, while Transjugular Intrahepatic Portosystemic Shunt (TIPS) has been revealed as the most successful measure. We report a hemodynamically unstable patient with a history of Ulcerative Colitis (UC) and Primary Sclerosing Cholangitis (PSC) with colostomy, because of colon cancer who presented with massive parastomal bleeding. Non-operative treatments and TIPS failed to control the symptoms. Color Doppler ultrasound showed a hepato-fugal flow. The direct antegrade technique, using Sodium Tetradecyl Sulfate (STS 1%) and glue-Lipiodol, was applied under ultrasonography guidance, and complete stoppage of bleeding was achieved. No immediate or late complication or follow-up recurrence were noted after 8 months. In case of hepatofugal flow, direct percutaneous mesenteric parastomal venous access and sclerotherapy is a rapid and relatively safe procedure for parastomal variceal bleeding. © 2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.

Style	Citing Format
MLA	Yazdi NA, et al.. "Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report." Gastroenterology and Hepatology from Bed to Bench, vol. 13, no. 1, 2020, pp. 90-94.
APA	Yazdi NA, Aletaha N, Mehrabinejad MM, Dehnavi AZ, Yazdi HR (2020). Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report. Gastroenterology and Hepatology from Bed to Bench, 13(1), 90-94.
Chicago	Yazdi NA, Aletaha N, Mehrabinejad MM, Dehnavi AZ, Yazdi HR. "Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report." Gastroenterology and Hepatology from Bed to Bench 13, no. 1 (2020): 90-94.
Harvard	Yazdi NA et al. (2020) 'Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report', Gastroenterology and Hepatology from Bed to Bench, 13(1), pp. 90-94.
Vancouver	Yazdi NA, Aletaha N, Mehrabinejad MM, Dehnavi AZ, Yazdi HR. Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report. Gastroenterology and Hepatology from Bed to Bench. 2020;13(1):90-94.
BibTex	@article{ author = {Yazdi NA and Aletaha N and Mehrabinejad MM and Dehnavi AZ and Yazdi HR}, title = {Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report}, journal = {Gastroenterology and Hepatology from Bed to Bench}, volume = {13}, number = {1}, pages = {90-94}, year = {2020} }
RIS	TY - JOUR AU - Yazdi NA AU - Aletaha N AU - Mehrabinejad MM AU - Dehnavi AZ AU - Yazdi HR TI - Intractable Parastomal Bleeding in a Portal Hypertensive Patient Managed by Direct Sclerotherapy: A Case Report JO - Gastroenterology and Hepatology from Bed to Bench VL - 13 IS - 1 SP - 90 EP - 94 PY - 2020 ER -

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