Abstract
The patient was a 49-year-old woman who had been treated by sustained chemotherapy after sigmoidectomy and colostomy for sigmoid colon cancer with multiple hepatic, pulmonary, and peritoneal metastases. The patient went into hemorrhagic shock due to bleeding from the surgical stoma 9 months after the operation, and was diagnosed with bleeding stromal varices by a contrast-enhanced abdominal CT scan. We had great difficulties in the hemostasis and conservative therapy was difficult. We determined her to be a candidate for variceral obliteration. Percutaneous transhepatic portography identified the varices which drained into the left superficial epigastric vein from the inferior mesenteric vein. After obliteration of the outpouring vein, the verices were also obliterated under balloon obliteration. The hemostasis was obtained immediately after the obliteration. The patient was discharged from the hospital on the 5th day after the obliteration and soon her sustained chemotherapy was restarted.
Stromal varices are a relatively rare complication in patients with surgical stoma presented with portal hypertension. We present a case of uncontrolled bleeding from the stromal varices in which percutaneous transhepatic variceral obliteration was successful, together with a review of the literature.
