Mónica Garrido1, Belarmino Gonçalves2, Sofia Ferreira3, Marta Rocha1, Marta Salgado1,4, Isabel Pedroto1,4. 1. Department of Gastroenterology, Porto University Hospital Centre, Porto, Portugal. 2. Department of Interventional Radiology, Portuguese Oncology Institute, Porto, Portugal. 3. Liver Transplant Unit, Porto University Hospital Centre, Porto, Portugal. 4. Institute of Biomedical Sciences of Abel Salazar (ICBAS), University of Porto, Porto, Portugal.
Abstract
BACKGROUND: Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Despite their significant prevalence among cirrhotic patients, clinically important bleeding occurs only in a minority. Various treatment options are available, with endoscopic therapies being widely used, and both interventional radiology and surgery being considered for refractory bleeding rectal varices. CASE: We report the case of a 61-year-old male with hepatic cirrhosis and bleedingrectal varices refractory to endoscopic therapy, successfully managed with a combination of transjugular intrahepatic portosystemic shunt (TIPS) and selective variceal embolization. CONCLUSIONS: Radiological techniques are effective options for refractory bleeding. Adding embolization to TIPS implantation could represent a valid adjunctive measure for haemostasis of recurrent rectal variceal bleeding.
BACKGROUND: Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Despite their significant prevalence among cirrhotic patients, clinically important bleeding occurs only in a minority. Various treatment options are available, with endoscopic therapies being widely used, and both interventional radiology and surgery being considered for refractory bleeding rectal varices. CASE: We report the case of a 61-year-old male with hepatic cirrhosis and bleedingrectal varices refractory to endoscopic therapy, successfully managed with a combination of transjugular intrahepatic portosystemic shunt (TIPS) and selective variceal embolization. CONCLUSIONS: Radiological techniques are effective options for refractory bleeding. Adding embolization to TIPS implantation could represent a valid adjunctive measure for haemostasis of recurrent rectal variceal bleeding.
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