Percutaneous transhepatic embolization of rectal varices with a new mixture and vascular plug

Posted By Ahmed Abdel Aal
Percutaneous transhepatic embolization of rectal varices with a new mixture and vascular plug

A case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment options for rectal variceal bleeding are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2). To our knowledge, the use of this new mixture together with the AVP 2 in the treatment of rectal varices has not been previously published in literature. Our case provides an alternative treatment modality that can be used for the treatment of rectal varices, when TIPS and endoscopic management fails or is contraindicated.

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