Ectopic stomal varices are an unusual cause of gastrointestinal hemorrhage. The term "ectopic stomal varices" means abnormally dilated veins that have developed in the stomal mucosa. We describe the 2D reformatted and 3D volume rendered images by MDCT in a patient with an episode of acute bleeding from the colonic stoma. This case indicates that the 2D reformatted and 3D volume rendered images are useful to detect this rare complication of portal hypertension, and they help to tailor adequate treatment for the patients with bleeding from stomal varices.
Varicose Veins/*complications/*radiography/therapy ; Tomography, X-Ray Computed/*methods ; Recurrence ; Male ; Ligation ; Imaging, Three-Dimensional ; Humans ; Gastrointestinal Hemorrhage/*etiology/*radiography/therapy ; *Colostomy ; Aged

OBJECTIVE: To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. MATERIALS AND METHODS: From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. RESULTS: A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. CONCLUSION: Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.
Catheters/adverse effects ; Femoral Vein ; Fluoroscopy/methods ; Humans ; Laser Therapy/methods ; Radiography, Interventional/methods ; *Saphenous Vein/radiography/surgery ; Sclerosing Solutions/*administration & dosage/chemistry ; Sclerotherapy/adverse effects/instrumentation/*methods ; Treatment Outcome ; Varicose Veins/radiography/*therapy ; Venous Insufficiency/surgery