A case of recurrent bleeding stomal varix controlled using embolization with a liquid copolymer: an effective therapy for palliation.

BACKGROUND

Bleeding stomal varices (BSV) is a common problem in patients undergoing an ileostomy or colostomy. The diagnosis is often delayed as blood loss occurs in small amounts over a period of time, usually from minor anastamosing blood vessels at the ostomy site making it hard to diagnose. Treatment options can be limited in terms of modalities and efficacy.

CASE: We describe a case of recurrent bleeding from a superior mesenteric vein (SMV) that was inadvertently sewn into the ileostomy site during surgery. Bleeding was initially controlled with percutaneous SMV coil embolization, but the bleeding persisted, only to be controlled finally by embolization using a liquid copolymer. Though the patient was terminally ill, his quality of life significantly improved thereafter, he did not have any further bleeding episodes during 10 months of follow-up.

CONCLUSION

Embolization of a recurrent bleeding stomal varix with a liquid copolymer may be an effective therapeutic option.