Caput medusae: peristomal varices.

Abstract

Peristomal varices are a manifestation of severe liver disease and portal hypertension. Unfortunately, they may bleed profusely, usually as a result of pressure from a hard faceplate on the appliance or denudation from leakage of stomal output. This article provides a case study, followed by a review of the causes, the medical management, and surgical management of this condition. Some implications for ET nurses are also given.