Bleeding ileal conduit varices in a postoperative patient of urinary bladder carcinoma: percutaneous transhepatic variceal embolization to the rescue

The ileal conduit is one of the most commonly performed urinary diversion procedures for muscle-invasive bladder cancer, and among the various complications, bleeding from an ileal conduit is rare. In patients with recurrent stomal haemorrhage, one must consider the possibility of atypical varices and assess for liver cirrhosis if it has not been previously established. Here, we describe a case of bleeding ectopic varices at the ileal conduit site in a patient in his 50s who underwent surgery for urinary bladder carcinoma, which was successfully managed through percutaneous transhepatic glue embolisation. Selective embolisation of these ectopic varices with coils or glue produces impressive results, offering the benefit of being minimally invasive, and can be considered an initial treatment option for stomal variceal bleeding. Other techniques, such as transjugular intrahepatic portosystemic shunt or antegrade and retrograde variceal occlusion using balloon or plug assistance, can also be attempted to eliminate varices.