Successful hemostasis of intractable rectal variceal bleeding using variceal embolization

Portal hypertension causes portosystemic shunting along the gastrointestinal tract,resulting in gastrointestinalvarices.Rectal varices and their bleeding is a rare complication,but it can be fatal without appropriate treatment.However,because of its rarity,no established treatment strategy is yet av...

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Published inWorld journal of gastroenterology : WJG Vol. 21; no. 8; pp. 2558 - 2562
Main Authors Ahn, Sung Soo, Kim, Eun Hye, Kim, Man Deuk, Lee, Won Jae, Kim, Seung Up
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.02.2015
Subjects
Adult
Case Report
Ectopic
Embolization, Therapeutic
Female
Gastrointestinal Hemorrhage - diagnosis
Gastrointestinal Hemorrhage - etiology
Gastrointestinal Hemorrhage - therapy
Humans
Hypertension, Portal - diagnosis
Hypertension, Portal - etiology
intrav
Liver Cirrhosis, Alcoholic - complications
Liver Cirrhosis, Alcoholic - diagnosis
Portasystemic Shunt, Transjugular Intrahepatic
Rectum - blood supply
Recurrence
Sigmoidoscopy
Tomography, X-Ray Computed
Treatment Outcome
varices;Rectal
varices;Transjugular
Varicose Veins - diagnosis
Varicose Veins - etiology
Varicose Veins - therapy
Variceal bleeding
Embolization
Rectal varices
Ectopic varices
Transjugular intravenous portosystemic shunt
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Summary:Portal hypertension causes portosystemic shunting along the gastrointestinal tract,resulting in gastrointestinalvarices.Rectal varices and their bleeding is a rare complication,but it can be fatal without appropriate treatment.However,because of its rarity,no established treatment strategy is yet available.In the setting of intractable rectal variceal bleeding,a transjugular intravenous portosystemic shunt can be a treatment of choice to enable portal decompression and thus achieve hemostasis.However,in the case of recurrent rectal variceal bleeding despite successful transjugular intravenous portosystemic shunt,alternative measures to control bleeding are required.Here,we report on a patient with liver cirrhosis who experienced recurrent rectal variceal bleeding even after successful transjugular intravenous portosystemic shunt and was successfully treated with variceal embolization.
Bibliography:Ectopic varices;Rectal varices;Transjugular intrav
Sung Soo Ahn;Eun Hye Kim;Man Deuk Kim;Won Jae Lee;Seung Up Kim;Department of Internal Medicine, Yonsei University College of Medicine;Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine;Seoul Gookgwain School;Institute of Gastroenterology, Yonsei University College of Medicine;Liver Cirrhosis Clinical Research Center
Portal hypertension causes portosystemic shunting along the gastrointestinal tract,resulting in gastrointestinalvarices.Rectal varices and their bleeding is a rare complication,but it can be fatal without appropriate treatment.However,because of its rarity,no established treatment strategy is yet available.In the setting of intractable rectal variceal bleeding,a transjugular intravenous portosystemic shunt can be a treatment of choice to enable portal decompression and thus achieve hemostasis.However,in the case of recurrent rectal variceal bleeding despite successful transjugular intravenous portosystemic shunt,alternative measures to control bleeding are required.Here,we report on a patient with liver cirrhosis who experienced recurrent rectal variceal bleeding even after successful transjugular intravenous portosystemic shunt and was successfully treated with variceal embolization.
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Telephone: +82-2-22281982 Fax: +82-2-3936884
Author contributions: Ahn SS designed the report and wrote the paper; Kim MD designed the concept and performed varceal embolization; Kim EH and Lee WJ drafted the article and revised it; Kim SU designed the concept and finally approved the paper.
Correspondence to: Seung Up Kim, MD, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. ksukorea@yuhs.ac
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i8.2558