Percutaneous transhepatic obliteration for massive variceal rectal bleeding

In patients with severe portal hypertension related to liver cirrhosis, recanalization of umbilical veins may lead to both development and rupture of massive anorectal varices. In this setting, while transjugular intrahepatic portosystemic shunt (TIPS) is considered as the treatment of choice, the management of these patients remains unclear in case of contraindications to TIPS. Laparoscopic division of massive portosystemic shunts has been reported to yield beneficial effects in patients with isolated hepatic encephalopathy but has never been attempted in a context of life-threatening lower gastrointestinal bleeding. In the present case report, we both describe the operative technique of laparoscopic division of recanalized umbilical veins to treat recurrent massive haemorrhage following rupture of giant rectal varices in a 68-year-old Child C cirrhotic patient contraindicated to TIPS and report the postoperative course of the patient.

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Laparoscopic Division of a Portosystemic Shunt for Recurrent Life-Threatening Rectal Variceal Bleeding: Report of a Case

Cauchy

Schwarz

Brustia

et al. 2014

Journal of Gastrointestinal Surgery

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Comparison of Percutaneous Transhepatic Variceal Embolization (PTVE) Followed by Partial Splenic Embolization versus PTVE Alone for the Treatment of Acute Esophagogastric Variceal Massive Hemorrhage

Duan

Zhang

Han

et al. 2014

Journal of Vascular and Interventional Radiology

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Balloon-occluded antegrade transvenous obliteration of rectal varices: A case report

Abrishami

Zadeh

Khalili

et al. 2021

Radiology Case Reports

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Percutaneous transhepatic obliteration for massive variceal rectal bleeding

Cited by 6 publications

References 11 publications

Laparoscopic Division of a Portosystemic Shunt for Recurrent Life-Threatening Rectal Variceal Bleeding: Report of a Case

Laparoscopic Division of a Portosystemic Shunt for Recurrent Life-Threatening Rectal Variceal Bleeding: Report of a Case

Comparison of Percutaneous Transhepatic Variceal Embolization (PTVE) Followed by Partial Splenic Embolization versus PTVE Alone for the Treatment of Acute Esophagogastric Variceal Massive Hemorrhage

Balloon-occluded antegrade transvenous obliteration of rectal varices: A case report

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