Direct percutaneous embolization of ileal conduit stomal varices with gelatin sponge particles and ethanolamine oleate iopamidol mixture

The present case report concerns an 80-year-old obese woman with liver cirrhosis who presented with acute ileal conduit stomal hemorrhage. Due to the inherent challenges associated with ultrasound visualization of the portal vein in obese patients, a direct percutaneous approach was employed over the conventional transhepatic route. The feeding ileal vein was directly punctured under ultrasound guidance. A 5Fr sheath and a balloon microcatheter were placed, followed by the injection of a mixture of gelatin sponge particles and 5% ethanolamine oleate iopamidol under balloon occlusion. No recurrent bleeding occurred during the 6-month follow-up period. This case suggests that direct percutaneous embolization with a mixture of gelatin sponge particles and 5% ethanolamine oleate iopamidol may offer a safe and effective treatment option for stomal varices.