Life-Threatening Bleeding from Peristomal Varices after Cystoprostatectomy: Multimodal Approach in a Cirrhotic, Encephalopathic Patient with Severe Portal Hypertension
Joint Authors
Staubli, Sergej E. L.
Gramann, Tobias
Schwab, Christoph
Semela, David
Hechelhammer, Lukas
Engeler, Daniel S.
Abt, Dominik
Mordasini, Livio
Schmid, Hans-Peter
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-01-29
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
The bleeding of peristomal varices due to a portosystemic shunt is rare but potentially life-threatening in cirrhotic patients with portal hypertension.
The scarce case reports in the literature recommend transjugular intrahepatic portosystemic shunt (TIPS) to prevent further bleeding.
We report on a 72-year-old man who was referred to our hospital because of life-threatening bleeding from peristomal varices, three years after radical cystoprostatectomy for invasive bladder cancer.
CT imaging showed liver cirrhosis with a prominent portosystemic shunt leading to massively enlarged peristomal varices.
TIPS was taken into consideration, but not possible due to hepatic encephalopathy (HE).
Medical therapy with lactulose and the nonselective beta-blocker carvedilol was initiated to treat HE and portal hypertension.
In a second step, the portosystemic shunt was percutaneously embolized.
Here, we present a multimodal approach to treat intractable bleeding from peristomal varices in a patient with ileal conduit urinary diversion, not suitable for TIPS.
American Psychological Association (APA)
Staubli, Sergej E. L.& Gramann, Tobias& Schwab, Christoph& Semela, David& Hechelhammer, Lukas& Engeler, Daniel S.…[et al.]. 2015. Life-Threatening Bleeding from Peristomal Varices after Cystoprostatectomy: Multimodal Approach in a Cirrhotic, Encephalopathic Patient with Severe Portal Hypertension. Case Reports in Urology،Vol. 2015, no. 2015, pp.1-3.
https://search.emarefa.net/detail/BIM-1060275
Modern Language Association (MLA)
Staubli, Sergej E. L.…[et al.]. Life-Threatening Bleeding from Peristomal Varices after Cystoprostatectomy: Multimodal Approach in a Cirrhotic, Encephalopathic Patient with Severe Portal Hypertension. Case Reports in Urology No. 2015 (2015), pp.1-3.
https://search.emarefa.net/detail/BIM-1060275
American Medical Association (AMA)
Staubli, Sergej E. L.& Gramann, Tobias& Schwab, Christoph& Semela, David& Hechelhammer, Lukas& Engeler, Daniel S.…[et al.]. Life-Threatening Bleeding from Peristomal Varices after Cystoprostatectomy: Multimodal Approach in a Cirrhotic, Encephalopathic Patient with Severe Portal Hypertension. Case Reports in Urology. 2015. Vol. 2015, no. 2015, pp.1-3.
https://search.emarefa.net/detail/BIM-1060275
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1060275