ABSTRACT
Less than 5% of patients with liver cirrhosis (LC) with portal hypertension (PH) develop atypical shunt (in regions other than the esophagus or the stomach). Within this group are varices associated with a stoma, for example the ones associated with an uretero-ileostomy which are infrequent. They are a diagnostic and therapeutic challenge, as they can cause hemorrhages due to PH. We present a clinical case about stoma varicose bleeding as the latest guidelines for the management of PH do not mention them or their treatment due to their low incidence.(AU)
Subject(s)
Humans , Male , Middle Aged , Hypertension, Portal/complications , Thrombocytopenia , Hematuria , Gastrointestinal Hemorrhage , Liver Cirrhosis , Thrombosis , Inpatients , Physical Examination , Symptom Assessment , Neoplasm Recurrence, Local , Portal VeinABSTRACT
Less than 5% of patients with liver cirrhosis (LC) with portal hypertension (PH) develop atypical shunt (in regions other than the esophagus or the stomach). Within this group are varices associated with a stoma, for example the ones associated with an uretero-ileostomy which are infrequent. They are a diagnostic and therapeutic challenge, as they can cause hemorrhages due to PH. We present a clinical case about stoma varicose bleeding as the latest guidelines for the management of PH do not mention them or their treatment due to their low incidence.
Subject(s)
Hypertension, Portal , Portasystemic Shunt, Transjugular Intrahepatic , Thrombosis , Varicose Veins , Humans , Portasystemic Shunt, Transjugular Intrahepatic/adverse effects , Neoplasm Recurrence, Local , Hemorrhage/complications , Hypertension, Portal/complications , Hypertension, Portal/surgery , Varicose Veins/surgery , Thrombosis/complications , Liver Cirrhosis/complications , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Portal Vein , Treatment OutcomeABSTRACT
Colonic impaction due to a fecaloma is a very frequent complication in patients with chronic constipation. Most cases respond to conservative measures such as digital disimpaction or treatment with oral laxatives and enemas. However, in some cases fecalomas could be refractory to these treatments requiring aggressive measures such as endoscopic or surgical removal. Even more, there are a few cases of death reported as a complication of a fecaloma refractory to usual treatments. We report, for the first time, a case of a patient with a huge fecaloma refractory to oral laxative and enemas resolved conservatively with a single irrigation of a carbonated soft drink through a rectal probe.
