Balloon-occluded antegrade transvenous obliteration via transjugular intrahepatic access for bleeding rectal varices

• Main Authors: David S. Shin, MD, Andrew G. Kim, MD, Christopher R. Ingraham, MD
• Format: Article
• Language: English
• Published: Elsevier 2019-07-01
• Series: Radiology Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043319301554

Bleeding rectal varices in cirrhotic patients with portal hypertension can be difficult to treat endoscopically or surgically. Transjugular intrahepatic portosystemic shunt creation offers a minimally invasive method to effectively decompress the portal system but may be contraindicated in patients with poor hepatic reserve or hepatic encephalopathy. We present a case of a 44-year-old woman with persistent rectal variceal bleeding, who was a poor candidate for endoscopic intervention, surgery, or transjugular intrahepatic portosystemic shunt. We therefore performed balloon-occluded antegrade transvenous obliteration of the rectal varices via transjugular intrahepatic access, which effectively controlled her rectal bleeding. Keywords: Rectal varices, Portal hypertension, Cirrhosis, Gastrointestinal bleeding, Balloon-occluded antegrade transvenous obliteration (BATO)