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CASE REPORT
Year : 2020  |  Volume : 36  |  Issue : 2  |  Page : 130-132

Peristomal variceal hemorrhage at the ileal conduit site due to extrahepatic portosystemic shunt


Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD 57108, USA

Correspondence Address:
Smitha Narayana Gowda
Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD 57108
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/iju.IJU_292_19

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Peristomal variceal bleeding is a rare but known complication with portal hypertension. In patients with recurrent peristomal hemorrhage, atypical varices should be considered, and liver cirrhosis should be excluded even with normal liver function tests. We report a case of a 76-year-old male who presented with recurrent ileal conduit site peristomal hemorrhage without known chronic liver disease. His liver function tests were normal, but computed tomography of the abdomen and pelvis showed liver nodularity and peristomal varices. He was diagnosed to have cirrhosis with portal hypertension and further tested positive for active hepatitis C infection. The patient's extrahepatic portosystemic ileal conduit site shunt was successfully treated with transjugular intrahepatic portosystemic shunt and endovascular variceal coiling. This case identifies a situation where it is imperative to identify occult liver cirrhosis with portosystemic shunt as a cause of ileal conduit site recurrent stomal bleeding.


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