Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices
In patients with portal hypertension, bleeding from rectal varices is rare. However, it can be life-threatening. We report a case of massive bleeding from large rectal varices in a 59-year-old man with alcoholic cirrhosis. Emergent transjugular intrahepatic portosystemic shunt (TIPS) placement was p...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2015-08-01
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| Series: | Case Reports in Gastroenterology |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/439164 |
| _version_ | 1818230534348734464 |
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| author | S M Nazmus Sakib Katsuhiro Kobayashi Mohammed Jawed |
| author_facet | S M Nazmus Sakib Katsuhiro Kobayashi Mohammed Jawed |
| author_sort | S M Nazmus Sakib |
| collection | DOAJ |
| description | In patients with portal hypertension, bleeding from rectal varices is rare. However, it can be life-threatening. We report a case of massive bleeding from large rectal varices in a 59-year-old man with alcoholic cirrhosis. Emergent transjugular intrahepatic portosystemic shunt (TIPS) placement was performed following failed local endoscopic therapy. Despite normalization of the portosystemic pressure gradient, the patient had another episode of massive bleeding on the following day. Embolization of the rectal varices via TIPS successfully stopped the bleeding. After the procedure, rapid decompensation of the cirrhosis led to severe encephalopathy, and death was observed. Although TIPSs have been reported to be useful in controlling bleeding from rectal varices, our case illustrates the potential pitfalls in using this technique in the treatment of rectal variceal bleeding. TIPSs may not be always successful in controlling massive bleeding from large rectal varices, even after normalization of portal hypertension. TIPSs can also be associated with life-threatening complications that may lead to early mortality. |
| first_indexed | 2024-12-12T10:36:01Z |
| format | Article |
| id | doaj.art-618510593fc24073a0c98d521d5e3054 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-12T10:36:01Z |
| publishDate | 2015-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-618510593fc24073a0c98d521d5e30542022-12-22T00:27:12ZengKarger PublishersCase Reports in Gastroenterology1662-06312015-08-019229630110.1159/000439164439164Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal VaricesS M Nazmus SakibKatsuhiro KobayashiMohammed JawedIn patients with portal hypertension, bleeding from rectal varices is rare. However, it can be life-threatening. We report a case of massive bleeding from large rectal varices in a 59-year-old man with alcoholic cirrhosis. Emergent transjugular intrahepatic portosystemic shunt (TIPS) placement was performed following failed local endoscopic therapy. Despite normalization of the portosystemic pressure gradient, the patient had another episode of massive bleeding on the following day. Embolization of the rectal varices via TIPS successfully stopped the bleeding. After the procedure, rapid decompensation of the cirrhosis led to severe encephalopathy, and death was observed. Although TIPSs have been reported to be useful in controlling bleeding from rectal varices, our case illustrates the potential pitfalls in using this technique in the treatment of rectal variceal bleeding. TIPSs may not be always successful in controlling massive bleeding from large rectal varices, even after normalization of portal hypertension. TIPSs can also be associated with life-threatening complications that may lead to early mortality.http://www.karger.com/Article/FullText/439164CirrhosisPortal hypertensionAnorectal varicesTransjugular intrahepatic portosystemic shuntEmbolizationLiver failureHepatic encephalopathy |
| spellingShingle | S M Nazmus Sakib Katsuhiro Kobayashi Mohammed Jawed Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices Case Reports in Gastroenterology Cirrhosis Portal hypertension Anorectal varices Transjugular intrahepatic portosystemic shunt Embolization Liver failure Hepatic encephalopathy |
| title | Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices |
| title_full | Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices |
| title_fullStr | Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices |
| title_full_unstemmed | Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices |
| title_short | Potential Pitfalls in Transjugular Portosystemic Shunt Placement for Bleeding Rectal Varices |
| title_sort | potential pitfalls in transjugular portosystemic shunt placement for bleeding rectal varices |
| topic | Cirrhosis Portal hypertension Anorectal varices Transjugular intrahepatic portosystemic shunt Embolization Liver failure Hepatic encephalopathy |
| url | http://www.karger.com/Article/FullText/439164 |
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