Rescue therapy for bleeding ectopic ileal varices with a transjugular intrahepatic portosystemic shunt and antegrade variceal embolization

Abstract

Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.

Keywords

• hypertension
• portal; liver cirrhosis; portasystemic shunt
• transjugular intrahepatic