Management of Refractory Esophageal Variceal Bleeding when TIPSS Is Not Possible: Review of a Challenging Case.

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY
Case Reports in Gastroenterology Pub Date : 2025-02-13 eCollection Date: 2025-01-01 DOI:10.1159/000543537
Abdulrahman Qatomah, Ali Bessissow, Yen-I Chen, Talat Bessissow, Amine Benmassaoud
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引用次数: 0

Abstract

Introduction: Esophageal variceal bleeding (EVB) is a common complication of portal hypertension. Guidelines recommend initiation of vasoactive agents in combination with antimicrobial therapy prior to endoscopic variceal ligation. In cases of refractory EVB, trans-jugular intrahepatic portosystemic shunt (TIPSS) is recommended; however, it is contraindicated in up to 35% of cases.

Case presentation: We report a case of a 61-year-old male newly diagnosed with hepatocellular carcinoma and extensive portal vein thrombosis. The patient developed a refractory EVB failing medical and endoscopic therapies which was successfully treated with transcutaneous left gastric vein embolization (LGVE).

Conclusion: LGVE could be contemplated in instances where anatomical complexities or contraindications to TIPSS arise.

简介:食管静脉曲张出血(EVB)是门静脉高压症的常见并发症:食管静脉曲张出血(EVB)是门静脉高压症的常见并发症。指南建议,在进行内镜下静脉曲张结扎术之前,应先使用血管活性药物,并结合抗菌治疗。对于难治性 EVB 病例,建议采用经颈静脉肝内门体分流术(TIPSS),但多达 35% 的病例禁用该疗法:我们报告了一例新诊断为肝细胞癌和广泛门静脉血栓形成的 61 岁男性病例。经皮左胃静脉栓塞术(LGVE)成功治疗了该患者:结论:在解剖复杂或有 TIPSS 禁忌症的情况下,可以考虑 LGVE。
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来源期刊
Case Reports in Gastroenterology
Case Reports in Gastroenterology Medicine-Gastroenterology
CiteScore
1.10
自引率
0.00%
发文量
99
审稿时长
7 weeks
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