DIAGNOSING STOMAL AND BLEEDING STOMAL VARICES

Abstract

　To date,the term "stomal varices" has been used to describe cases of venous dilatation in the stoma and peristoma,even though diagnostic criteria have not been well defined. We recently encountered eight patients thought to have stomal varices and studied them for determining reliable measures of diagnosis for this class of varices.
　Patients were five men and three women who had undergone surgery for colon cancer. All patients had diseases which included the following symptoms: elevated portal pressure; enlarged or engorged veins in the junction between the mucosa and either the stomal or peristomal skin; and changes in peristomal skin color. Varices were also present in the stomal mucosa in three cases.
　These findings suggest that the following factors are useful in diagnosing stomal varices.
1. Presence of a disease which can elevate portal pressure.
2. Presence of distended or enlarged veins in the peristomal skin and the junction between the mucosa and stomal skin.
3. Observance of a subtle discoloration in peristomal skin color.
4. Presence of stomal mucosal varices.
　We decided upon using the term "bleeding stomal varices" for describing the event when stomal varices are accompanied by bleeding as well as the above findings.