Radiology Case Reports (Nov 2021)

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

  • Alireza Abrishami, MD, MBA,
  • Arezou Hashem Zadeh, MD,
  • Nastaran Khalili, MD-MPH,
  • Hadi Rokni Yazdi, MD

Journal volume & issue
Vol. 16, no. 11
pp. 3363 – 3368

Abstract

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Patients with liver cirrhosis frequently experience rectal variceal bleeding subsequent to portal hypertension. Unlike gastroesophageal variceal bleeding, a well-established guideline does not exist in terms of management of bleeding rectal varices. A 75-year-old male with non-alcoholic-steatohepatitis induced cirrhosis presented with a 3-day history of severe rectorrhagia. Considering patient's clinical history, TIPS was not performed and thus, a novel endovascular technique termed balloon-occluded antegrade transvenous obliteration was considered. Under conscious sedation, an occlusion was made through balloon catheter by sclerotic agents including air/sodium tetradecyl sulfate/Lipiodol. After the procedure, and in the 6 months follow up period the patient's hemodynamic status was stable and he recovered without any serious complications. Balloon-occluded antegrade transvenous obliteration is a feasible and safe modality for treating rectal varices bleeding and could be used as an alternative approach in patients with contraindications to traditional treatments.

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