Plug-assisted retrograde transvenous obliteration via gastrocaval shunt for the gastric variceal bleeding: A case report

Medicine (Baltimore). 2021 Dec 10;100(49):e28107. doi: 10.1097/MD.0000000000028107.

Abstract

Rationale: Most gastric varices at the fundus drain into the left renal vein via the gastrorenal shunt (80-85% of cases) or the inferior vena cava via the gastrocaval shunt (10-15%). Therefore, plug-assisted retrograde transvenous obliteration (PARTO) is usually performed via a gastrorenal shunt. Here, we report a case of gastric varix treated with PARTO via a gastrocaval shunt.

Patient concerns: A 46-year-old woman with hepatitis B virus and liver cirrhosis visited the emergency room in our hospital with the main symptom of hematemesis and hematochezia.

Diagnoses: Endoscopy and computed tomography (CT) revealed a gastric varix and thrombotic-occluded transjugular intrahepatic portosystemic shunt (TIPS) stent.

Interventions: The patient underwent PARTO via a gastrocaval shunt to manage gastric variceal bleeding after failed TIPS revision.

Outcomes: On CT, the gastric varix completely disappeared. The patient did not experience any additional bleeding events.

Lessons: PARTO via a gastrocaval shunt is safe and effective.

Publication types

  • Case Reports

MeSH terms

  • Balloon Occlusion*
  • Endoscopy, Gastrointestinal
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / surgery*
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery*
  • Hematemesis
  • Humans
  • Middle Aged
  • Surgical Instruments
  • Treatment Outcome