PMC4602545_01
PMC4602545_02
Contrast-enhanced CT scan demonstrated ectopic varices at parastomal site (arrows). CT = computed tomography.
medi-94-e406-g001.jpg
PMC4602545_02_medi-94-e406-g001.jpg
F1
A contrast-enhanced abdominal computed tomography (CT) scan revealed large ectopic varices around the colostomy site (Figure 1).
(A) Percutaneous transhepatic portal venography revealed widened portal vein trunk, spleen vein, and IMV. (B) Venography showed a complex network of parastomal variceal vessels arising from the IMV. Communicating veins to systemic circulation can be noticed (arrows). (C) Embolization using Onyx LES (arrows) in combination with coils (arrowheads) via transhepatic approach. IMV = inferior mesenteric vein, LES = liquid embolic system, PV = portal vein trunk, SV = spleen vein.
medi-94-e406-g002.jpg
PMC4602545_02_medi-94-e406-g002.jpg
F2
Portal venography via the percutaneous transhepatic approach demonstrated that the varices arose from the inferior mesenteric vein (Figure 2A-B). Ectopic varices were embolized using a combination of coils and the Onyx 18 LES (Figure 2C).
Postembolization nonenhanced CT scan confirmed a complete occlusion of the variceal vessels. CT = computed tomography.
medi-94-e406-g003.jpg
PMC4602545_02_medi-94-e406-g003.jpg
F3
An additional CT scan demonstrated complete occlusion of the parastomal varices (Figure 3).