{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T07:50:47Z","timestamp":1767772247278,"version":"3.37.3"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Urology"],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p>The bleeding of peristomal varices due to a portosystemic shunt is rare but potentially life-threatening in cirrhotic patients with portal hypertension. The scarce case reports in the literature recommend transjugular intrahepatic portosystemic shunt (TIPS) to prevent further bleeding. We report on a 72-year-old man who was referred to our hospital because of life-threatening bleeding from peristomal varices, three years after radical cystoprostatectomy for invasive bladder cancer. CT imaging showed liver cirrhosis with a prominent portosystemic shunt leading to massively enlarged peristomal varices. TIPS was taken into consideration, but not possible due to hepatic encephalopathy (HE). Medical therapy with lactulose and the nonselective beta-blocker carvedilol was initiated to treat HE and portal hypertension. In a second step, the portosystemic shunt was percutaneously embolized. Here, we present a multimodal approach to treat intractable bleeding from peristomal varices in a patient with ileal conduit urinary diversion, not suitable for TIPS.<\/jats:p>","DOI":"10.1155\/2015\/785010","type":"journal-article","created":{"date-parts":[[2015,1,29]],"date-time":"2015-01-29T16:03:42Z","timestamp":1422547422000},"page":"1-3","source":"Crossref","is-referenced-by-count":3,"title":["Life-Threatening Bleeding from Peristomal Varices after Cystoprostatectomy: Multimodal Approach in a Cirrhotic, Encephalopathic Patient with Severe Portal Hypertension"],"prefix":"10.1155","volume":"2015","author":[{"given":"Sergej E. L.","family":"Staubli","sequence":"first","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Gramann","sequence":"additional","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Semela","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Hechelhammer","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S.","family":"Engeler","sequence":"additional","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7892-9766","authenticated-orcid":true,"given":"Hans-Peter","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Abt","sequence":"additional","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livio","family":"Mordasini","sequence":"additional","affiliation":[{"name":"Department of Urology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.12.047"},{"issue":"11","key":"2","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1080\/11024150201680017","volume":"168","year":"2002","journal-title":"The European Journal of Surgery"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-006-0564-y"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(01)64058-8"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/s0090-4295(97)00267-7"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.31250"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5710.633"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2007.1.2.159"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-009-9536-4"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-004-0148-8"}],"container-title":["Case Reports in Urology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/criu\/2015\/785010.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criu\/2015\/785010.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criu\/2015\/785010.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,23]],"date-time":"2017-06-23T00:36:15Z","timestamp":1498178175000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/criu\/2015\/785010\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015]]},"references-count":10,"alternative-id":["785010","785010"],"URL":"https:\/\/doi.org\/10.1155\/2015\/785010","relation":{},"ISSN":["2090-696X","2090-6978"],"issn-type":[{"type":"print","value":"2090-696X"},{"type":"electronic","value":"2090-6978"}],"subject":[],"published":{"date-parts":[[2015]]}}}