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[Embolization of recurrent bleeding jejunal varices].

B Robert¹, T Yzet, E Bartoli

¹Service d'imagerie médicale, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 01, France. robert.brice@chu-amiens.fr

Gastroenterologie Clinique Et Biologique

|January 9, 2010

Summary

Recurrent digestive bleeding from ectopic jejunal varices in a cirrhotic patient was successfully treated by transjugular intrahepatic porto-systemic shunt (TIPS) embolization. This minimally invasive procedure prevented recurrence for 24 months, offering a safe and effective treatment option.

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Area of Science:

Interventional Radiology
Hepatology
Gastroenterology

Background:

Portal hypertension is a common complication of liver cirrhosis.
Ectopic varices can cause severe, life-threatening gastrointestinal bleeding.
Transjugular intrahepatic porto-systemic shunt (TIPS) is used to manage portal hypertension but can sometimes lead to variceal complications.

Observation:

A 51-year-old cirrhotic patient presented with recurrent digestive hemorrhage due to bleeding ectopic jejunal varices.
The patient had previously undergone TIPS placement for similar issues.
The ectopic varices were successfully embolized using an innovative transjugular and trans-TIPS approach.

Findings:

The embolization procedure was technically successful and performed without complications.
No recurrence of bleeding was observed during a 24-month follow-up period.
This demonstrates the efficacy of the transjugular and trans-TIPS route for treating bleeding ectopic jejunal varices.

Implications:

This case highlights a viable treatment strategy for refractory bleeding from ectopic varices in cirrhotic patients post-TIPS.
Minimally invasive embolization offers a potentially safer alternative to surgical interventions.
Further studies are warranted to evaluate the long-term outcomes of this technique.