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

• Tác giả: Amine Benmassaoud, Ali Bessissow, Talat Bessissow, Yen-I Chen, Abdulrahman Qatomah
• Ngôn ngữ: eng
• Ký hiệu phân loại: 664.72273 Grains, other seeds, their derived products
• Thông tin xuất bản: Switzerland : Case reports in gastroenterology , 2025
• Bộ sưu tập: NCBI
• ID: 56910

Tóm tắt

 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.