A Case of Stomal Varices and Esophageal Varices Associated with Idiopathic Portal Hypertension

Taihei Koh, Kimihiko Nakagawa, Hiroyuki Konishi, Yumiko Takahashi, Toyokazu Aono, Takeshi Moritomo

The Department of Surgery, Izumisano Hospital

Stomal varices are very rare, with only one case having been reported in Japan. We report herein a case of stomal varices and esophageal varices associated with idiopathic portal hypertension. The patient, a 40-year-old man, who underwent Miles' operation because of rectal cancer in October 1988, had complained of stomal bleeding since December 1989. Because we could not diagnose his condition as stomal varices and idiopathic portal hypertension, we reconstructed a new stoma in July 1990. We then recognized that this case was similar to the cases of stomal varices reported in the English literature. We therefore diagnosed this case as stomal varices and esophageal varices associated with idiopathic portal hypertension. We performed esophageal transection and spleno-renal shunt in May 1991. In cases of poor hepatic function, local procedures like sclerotherapy or mucocutaneous disconnection should be considered first. But in cases of good hepatic function, portasystemic shunting is more effective and should be chosen.

Key words
stomal varices, idiopathic portal hypertension, portasystemic shunting

Reprint requests
Kimihiko Nakagawa The Department Surgery, Izumisano Hospital
3-2-1 Ichibanishi, Izumisano, 598 JAPAN

Accepted
October 13, 1993

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