Plug-assisted retrograde transvenous obliteration via gastrocaval shunt for the gastric variceal bleeding: A case report. Issue 49 (10th December 2021)

• Record Type: Journal Article
• Authors: Jang, Joo Yeon; Jeon, Ung Bae; Kim, Jin Hyeok; Kim, Tae Un; Ryu, Hwaseong; Cho, Mong; Hong, Young Mi; Yoon, Ki Tae
• Editors: Saranathan., Maya
• Is Part Of: Medicine. Volume 100:Issue 49(2021)
• Page Start: e28107
• Publication Date: 2021-12-10
• Subjects: case report -- gastric varix -- gastrocaval shunt -- liver cirrhosis -- plug-assisted retrograde transvenous obliteration; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000028107
• Languages: English
• ISSNs: 0025-7974

Abstract

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.