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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 4/2015

01-08-2015 | Letter to the Editor

Gastric Variceal Hemorrhage in a Noncirrhotic Patient Treated with Balloon-Occluded Retrograde Transvenous Obliteration

Authors: Jaap W. Ottevanger, Carla S. P. van Rijswijk, Bart van Hoek, Mark C. Burgmans

Published in: CardioVascular and Interventional Radiology | Issue 4/2015

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Excerpt

We read with great interest the recent article by Saad et al. [1]. We fully agree with the authors that balloon-occluded retrograde transvenous obliteration (BRTO) is a valuable treatment that can be used as an alternative to transjugular intrahepatic portosystemic shunt (TIPS). BRTO is also an excellent treatment option in patients for whom TIPS would not be beneficial. Gastric varices most commonly occur in patients with portal hypertension due to cirrhosis. Yet gastric varices may also develop in patients without underlying liver cirrhosis, and TIPS may not be beneficial or possible in these patients. BRTO is preferred over TIPS in such cases. We present a case of BRTO in a patient with active hemorrhage from gastric varices that were due to post pancreatitis splenic vein occlusion. …
Literature
1.
Saad WE, Simon PO Jr, Rose SC (2014) Balloon-occluded retrograde transvenous obliteration of gastric varices. Cardiovasc Intervent Radiol 37:299–315PubMedCrossRef
2.
Sarin SK, Lahoti D, Saxena SP et al (1992) Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatology 16:1343–1349PubMedCrossRef
3.
Butler JR, Eckert GJ, Zyromski NJ et al (2011) Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB 13:839–845PubMedCentralPubMedCrossRef
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Tripathi D, Therapondos G, Jackson E et al (2002) The role of the transjugular intrahepatic portosystemic stent shunt (TIPSS) in the management of bleeding gastric varices: clinical and haemodynamic correlations. Gut 51:270–274PubMedCentralPubMedCrossRef
5.
Saad WE, Darcy MD (2011) Transjugular intrahepatic portosystemic shunt (TIPS) versus balloon-occluded retrograde transvenous obliteration (BRTO) for the management of gastric varices. Semin Intervent Radiol 28:339–349PubMedCentralPubMedCrossRef
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Arai H, Abe T, Takagi H, Mori M (2006) Efficacy of balloon-occluded retrograde transvenous obliteration, percutaneous transhepatic obliteration and combined techniques for the management of gastric fundal varices. World J Gastroenterol 12:3866–3873PubMedCentralPubMed
Metadata
Title
Gastric Variceal Hemorrhage in a Noncirrhotic Patient Treated with Balloon-Occluded Retrograde Transvenous Obliteration
Authors
Jaap W. Ottevanger
Carla S. P. van Rijswijk
Bart van Hoek
Mark C. Burgmans
Publication date
01-08-2015
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 4/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-014-0942-x

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