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KMID : 0614620180710040234
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Korean Journal of Gastroenterology
2018 Volume.71 No. 4 p.234 ~ p.238
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Successful Transjugular Intrahepatic Portosystemic Shunt with Embolization Subsequent to Endoscopic Variceal Band Ligation for Bleeding Anorectal Varices
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Park Sang-Woo
Jun Chung-Hwan
Choi Sung-Kyu
Kim Hyun-Soo
Park Chang-Hwan
Rew Jong-Sun
Park Sun-Young
Cho Eun-Ae
Kim Jae-Kyu
Kim Hyoung-Ook
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Abstract
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Anorectal variceal bleeding is a rare occurrence; however, in such event, it could be fatal due to large size and high blood flow rate of varices. However, to date, there is no standardized treatment modality. Although endoscopic treatment can be provided, in cases of recurrent anorectal variceal bleeding, other therapeutic modalities for hemostasis are necessary. Here, we present a case of 58-year-old female patient with liver cirrhosis, who suffered from massive bleeding of anorectal varices. Endoscopic variceal band ligation was performed for primary hemostasis. Additionally, transjugular intrahepatic portosystemic shunt (TIPS) with embolization was performed to reduce the risk of rebleeding. Following the procedure, she had no further bleeding episodes, and the size of anorectal varices decreased, as seen on an abdomino-pelvic computed tomography. Our case illustrates the effectiveness of combined radiological intervention of TIPS with embolization after endoscopic hemostasis, for variceal obliteration and prevention of rebleeding.
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KEYWORD
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Varices, Treatment, Hemostasis, Portosystemic shunt, Portal hypertension
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