Peristomal varices after proctocolectomy in patients with primary sclerosing cholangitis.

Abstract:

:Primary sclerosing cholangitis is a chronic cholestatic liver disease that is commonly associated with chronic ulcerative colitis. We observed the development of varices in the abdominal wall surrounding the ileostomy stoma of patients with primary sclerosing cholangitis who underwent proctocolectomy and ileostomy for chronic ulcerative colitis. In 10 of 19 patients, the development of peristomal varices was documented 12-133 mo after operation. Risk factors for the development of peristomal varices included splenomegaly, esophageal varices, advanced histologic stage at liver biopsy, low serum albumin, thrombocytopenia, and an increased prothrombin time. Recurrent bleeding from peristomal varices was a major problem; 7 of 10 patients required repeated blood transfusions. The only therapy of long-term benefit was surgical decompression of the portal venous system in 1 patient and liver transplantation in a second patient. In contrast, there was no perirectal bleeding in 4 patients with primary sclerosing cholangitis who underwent proctocolectomy with an ileoanal anastomosis.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Wiesner RH,LaRusso NF,Dozois RR,Beaver SJ

doi

10.1016/0016-5085(86)90926-1

subject

Has Abstract

pub_date

1986-02-01 00:00:00

pages

316-22

issue

2

eissn

0016-5085

issn

1528-0012

pii

0016-5085(86)90926-1

journal_volume

90

pub_type

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