Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling
A 57-year-old male with heart failure and decompensated alcoholic liver cirrhosis presented with recurrent haematochesia due to rectal varices. After multiple failed therapy with endoscopic band ligation and surgical sclerotherapy, a discussion with an interventional radiologist was arranged. A tran...
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| Format: | Article |
| Language: | English |
| Published: |
SMC MEDIA SRL
2023-06-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/3930 |
| _version_ | 1797782615099441152 |
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| author | Justine Auxilia Irene Chinnappan Murtaza Shabbir Smit Deliwala Anish Bansal |
| author_facet | Justine Auxilia Irene Chinnappan Murtaza Shabbir Smit Deliwala Anish Bansal |
| author_sort | Justine Auxilia Irene Chinnappan |
| collection | DOAJ |
| description | A 57-year-old male with heart failure and decompensated alcoholic liver cirrhosis presented with recurrent haematochesia due to rectal varices. After multiple failed therapy with endoscopic band ligation and surgical sclerotherapy, a discussion with an interventional radiologist was arranged. A transjugular intrahepatic portosystemic shunt (TIPS) was deferred due to a history of heart failure. A shared decision to proceed with transhepatic Gelfoam® slurry embolisation with coiling was made. During the procedure, a variant anatomy of the superior rectal vein was identified. The superior rectal vein was found to drain directly into the left portal vein with no connectivity between the inferior mesenteric vein and the rectal varices. As planned, Gelfoam slurry embolisation and coiling was done to the left and right superior rectal vein along with the common trunk it drains. The patient did not develop any further episodes of gastrointestinal bleeding or worsening ascites on follow-up after 6 months. This case represents a successful treatment of bleeding rectal varices when TIPS is contraindicated. |
| first_indexed | 2024-03-13T00:13:27Z |
| format | Article |
| id | doaj.art-5180ad7015aa4b848bfedc2360d5f553 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-03-13T00:13:27Z |
| publishDate | 2023-06-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-5180ad7015aa4b848bfedc2360d5f5532023-07-12T07:29:01ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942023-06-0110.12890/2023_0039303465Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coilingJustine Auxilia Irene Chinnappan0https://orcid.org/0000-0002-6643-2549Murtaza Shabbir1Smit Deliwala2Anish Bansal3Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, MI, USADepartment of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, MI, USADivision of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USADepartment of Interventional Radiology, Michigan State University at Hurley Medical Center, Flint, MI, USAA 57-year-old male with heart failure and decompensated alcoholic liver cirrhosis presented with recurrent haematochesia due to rectal varices. After multiple failed therapy with endoscopic band ligation and surgical sclerotherapy, a discussion with an interventional radiologist was arranged. A transjugular intrahepatic portosystemic shunt (TIPS) was deferred due to a history of heart failure. A shared decision to proceed with transhepatic Gelfoam® slurry embolisation with coiling was made. During the procedure, a variant anatomy of the superior rectal vein was identified. The superior rectal vein was found to drain directly into the left portal vein with no connectivity between the inferior mesenteric vein and the rectal varices. As planned, Gelfoam slurry embolisation and coiling was done to the left and right superior rectal vein along with the common trunk it drains. The patient did not develop any further episodes of gastrointestinal bleeding or worsening ascites on follow-up after 6 months. This case represents a successful treatment of bleeding rectal varices when TIPS is contraindicated.https://www.ejcrim.com/index.php/EJCRIM/article/view/3930rectal varicesembolisationvarices coiling |
| spellingShingle | Justine Auxilia Irene Chinnappan Murtaza Shabbir Smit Deliwala Anish Bansal Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling European Journal of Case Reports in Internal Medicine rectal varices embolisation varices coiling |
| title | Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling |
| title_full | Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling |
| title_fullStr | Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling |
| title_full_unstemmed | Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling |
| title_short | Successful treatment of intractable rectal varices with Gelfoam slurry embolisation and coiling |
| title_sort | successful treatment of intractable rectal varices with gelfoam slurry embolisation and coiling |
| topic | rectal varices embolisation varices coiling |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/3930 |
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