Bleeding Colostomy Varices in a Cirrhotic Patient: Successful Management With Glue-Assisted Antegrade and Retrograde Transvenous Obliteration (GAARTO).

Parastomal varices are rare but potentially life-threatening complication of portal hypertension, often presenting with bleeding at stoma sites and frequently underrecognized due to their ectopic location. We report a 76-year-old man with decompensated cirrhosis and metastatic colon cancer who presented with recurrent colostomy site bleeding 14 years after left hemicolectomy. Computed tomography angiography revealed large portosystemic collaterals consistent with parastomal varices. Owing to high risk associated with transjugular intrahepatic portosystemic shunt, he was treated with glue-assisted antegrade and retrograde transvenous obliteration via inferior mesenteric vein access. The procedure achieved effective hemostasis without complications or recurrence. This case highlights the diagnostic value of computed tomography angiography and the therapeutic potential of glue-assisted antegrade and retrograde transvenous obliteration as a less encephalopathy-prone alternative to transjugular intrahepatic portosystemic shunt in high-risk patients.