Managing Recurrent Rectal Variceal Bleeding Secondary to Portal Hypertension With Liquid Embolics

Akram Al-Warqi; Rahil H Kassamali; Mohammed Khader; Ayman Elmagdoub; Ali Barah

doi:10.7759/cureus.21614

Managing Recurrent Rectal Variceal Bleeding Secondary to Portal Hypertension With Liquid Embolics

Cureus. 2022 Jan 25;14(1):e21614. doi: 10.7759/cureus.21614. eCollection 2022 Jan.

Authors

Akram Al-Warqi¹, Rahil H Kassamali^{2

3}, Mohammed Khader², Ayman Elmagdoub², Ali Barah²

Affiliations

¹ Radiology, Hamad Medical Corporation, Doha, QAT.
² Interventional Radiology, Hamad Medical Corporation, Doha, QAT.
³ Aston Medical School, Aston University, Birmingham, GBR.

Abstract

Rectal variceal bleeding is one of the rarer manifestations of portal hypertension caused by chronic liver disease. The management of these varices is very challenging. Our patient had portal vein thrombosis and presented with chronic recurrent rectal bleeding requiring transfusion secondary to rectal varices. The patient was treated from trans-splenic access with liquid embolics (sclerotherapy and glue) without balloon occlusion, leading to the successful cessation of his bleeding. Access hemostasis was achieved using a vascular plug in the access tract. There are no clear guidelines for the management of these patients. If rectal varices cannot be managed by colonoscopy, this approach to embolization with liquid embolic is an excellent minimally invasive alternative.

Keywords: amplatzer plug device; bato; glue; liquid embolic; liver cirrhosis; portal hypertension; portal vein thrombosis; rectal varices; sclerotherapy; trans-splenic.

Publication types

Case Reports