BLEEDING ILEAL CONDUIT STOMAL VARICES - DIAGNOSIS AND MANAGEMENT USING TRANSJUGULAR TRANSHEPATIC ANGIOGRAPHY AND EMBOLIZATION

An uncommon complication of ileal conduit urinary diversion is bleedin g varices at the stoma site. Variceal formation is a complication of p ortal hypertension, which is most commonly due to intrinsic liver dise ase. Problematic recurrent bleeding is usually managed locally or by p ortosystemic shunt. We report a case of recurrent, massive ileal condu it variceal hemorrhage in a patient without a significantly elevated p ortosystemic gradient. Therefore, this patient was not a candidate for a shunt procedure. Using a transjugular transhepatic approach to the portal vein, the varices were embolized to stasis without any complica tions. The patient has subsequently experienced no further bleeding ep isodes. (C) 1997, Elsevier Science Inc. All rights reserved.