Long-term outcome of percutaneous transhepatic venous embolization for ectopic peristomal variceal bleeding: A case report.
Jie Yuan, Tian Zhao, Huanling Zeng
✦ AI-curated · Sources linked
Case in brief
A patient with an ileal neobladder experienced recurrent hematuria due to ectopic peristomal varices linked to portal hypertension. The patient underwent two sessions of percutaneous transhepatic obliteration (PTO) for active bleeding. The first session resolved hematuria, but recanalization occurred, leading to a second successful PTO. After the second procedure, the patient remained free of hematuria for nearly four years, with minimal residual varices noted on follow-up imaging.
Diagnostic / clinical pearl
Clinicians should consider percutaneous transhepatic obliteration as a viable option for managing ectopic peristomal variceal bleeding, while remaining vigilant for potential recurrence due to underlying portal hypertension.
Why it matters
This case highlights the importance of long-term monitoring and the need for repeat interventions in patients with ectopic variceal bleeding, as embolization alone does not address the underlying portal hypertension.