Life-Threatening Aberrant Omental Variceal Bleeding with Interventional Treatment: A Case Report

Ectopic varices resulting from portal hypertension can cause fatal bleeding. Intra-abdominal hemorrhage from omental varices is rare, and no previous reports have described a direct connection between the splenic and ovarian veins. We report a case of intra-abdominal hemorrhage caused by an omental varix in a 49-year-old women with liver cirrhosis. Because she was hemodynamically unstable, surgical treatment was not feasible; therefore, an interventional procedure was planned. The varices originated from the splenic vein and drained into the ovarian vein. Through percutaneous portal venous access, the varices were embolized using coils and histoacryl via the splenic vein. Variceal bleeding ceased after the procedure; however, the patient died of multi-organ failure due to hemorrhagic shock and cardiac arrest. Thus, in patients with liver cirrhosis, it is essential to consider potential intra-abdominal hemorrhage from ectopic varices and identify the associated vessels to ensure prompt interventional management.