Peristomal varices after proctocolectomy in patients with primary sclerosing cholangitis

Russell H. Wiesner, Nicholas F La Russo, Roger R. Dozois, Sandra J. Beaver

Research output: Contribution to journalArticle

98 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)316-322
Number of pages7
JournalGastroenterology
Volume90
Issue number2
StatePublished - 1986

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Sclerosing Cholangitis
Varicose Veins
Ileostomy
Ulcerative Colitis
Hemorrhage
Portal System
Surgical Decompression
Esophageal and Gastric Varices
Prothrombin Time
Splenomegaly
Abdominal Wall
Serum Albumin
Blood Transfusion
Thrombocytopenia
Liver Transplantation
Liver Diseases
Biopsy
Liver

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Peristomal varices after proctocolectomy in patients with primary sclerosing cholangitis. / Wiesner, Russell H.; La Russo, Nicholas F; Dozois, Roger R.; Beaver, Sandra J.

In: Gastroenterology, Vol. 90, No. 2, 1986, p. 316-322.

Research output: Contribution to journalArticle

Wiesner, Russell H. ; La Russo, Nicholas F ; Dozois, Roger R. ; Beaver, Sandra J. / Peristomal varices after proctocolectomy in patients with primary sclerosing cholangitis. In: Gastroenterology. 1986 ; Vol. 90, No. 2. pp. 316-322.
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