A case report on use of TIPS for ectopic variceal bleeding

Area of Science:

• Gastroenterology and Hepatology
• Interventional Radiology

Background:

• Ectopic varices, rare causes of gastrointestinal bleeding, present unique management challenges due to low prevalence.
• Conventional treatments for variceal bleeding have limited evidence for ectopic varices.
• Transjugular Intrahepatic Portosystemic Shunt (TIPS) is explored as a therapeutic option.

Observation:

• A 65-year-old patient with liver cirrhosis and portal vein thrombosis presented with massive hematochezia and hemorrhagic shock.
• CT angiography and colonoscopy confirmed ascending colonic varices with a red whale sign.
• The patient was hemodynamically unstable requiring intensive care.

Findings:

• Transjugular Intrahepatic Portosystemic Shunt (TIPS) placement was successfully performed.
• The patient showed clinical improvement and was discharged after five days.
• TIPS effectively controlled the ectopic variceal bleeding.

Implications:

• This case report suggests TIPS is an effective treatment for bleeding ectopic varices, particularly in patients with portal hypertension.
• Further research is warranted to establish evidence-based guidelines for managing ectopic varices.
• Interventional radiology plays a crucial role in managing complex gastrointestinal bleeding.