Treating Untreatable Rectal Varices

• Main Authors: Mónica Garrido, Belarmino Gonçalves, Sofia Ferreira, Marta Rocha, Marta Salgado, Isabel Pedroto
• Format: Article
• Language: English
• Published: Karger Publishers 2019-02-01
• Series: GE: Portuguese Journal of Gastroenterology
• Subjects: Liver cirrhosis; Rectal varices; Transjugular intrahepatic portosystemic shunt; Therapeutic embolization
• Online Access: https://www.karger.com/Article/FullText/496121

Background: Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Despite their significant prevalence among cirrhotic patients, clinically important bleeding occurs only in a minority. Various treatment options are available, with endoscopic therapies being widely used, and both interventional radiology and surgery being considered for refractory bleeding rectal varices. Case: We report the case of a 61-year-old male with hepatic cirrhosis and bleeding rectal varices refractory to endoscopic therapy, successfully managed with a combination of transjugular intrahepatic portosystemic shunt (TIPS) and selective variceal embolization. Conclusions: Radiological techniques are effective options for refractory bleeding. Adding embolization to TIPS implantation could represent a valid adjunctive measure for haemostasis of recurrent rectal variceal bleeding.