Percutaneous transhepatic portal vein stenting as rescue treatment for recurrent oesophageal variceal bleeding in a 31-year-old woman with haepatocellular carcinoma in a non-cirrhotic liver

Colin Andreas Jan van Kalkeren, Zlatan Mujagic, Jef Verbeek, Michiel W de Haan

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

A 31-year-old woman with hepatocellular carcinoma suffered from recurrent oesophageal variceal bleeding due to portal hypertension, which was caused by severe compression of the portal vein by metastatic lymph nodes. Endoscopic band ligation and pharmacological treatment did not suffice to prevent recurrence of variceal bleeding. Eventually, after the fifth variceal bleeding within 6 months, the patient was admitted to the intensive care unit in a haemodynamic shock. A Sengstaken-Blakemore tube was inserted and all treatment options were discussed, but only percutaneous transhepatic recanalisation of the portal vein with stent placement to reduce portal vein pressure was thought to be feasible with any chance to relieve portal vein pressure. After successful portal vein stenting, our patient did not have any recurrent bleeding in the remaining year of her life. We suggest that percutaneous transhepatic portal vein stenting may be a feasible and adequate last line treatment for complications of portal hypertension.

Original languageEnglish
Article numbere235161
JournalBMJ case Reports
Volume13
Issue number12
DOIs
Publication statusPublished - 21 Dec 2020

Keywords

  • Adult
  • Carcinoma, Hepatocellular/complications
  • Esophageal and Gastric Varices/diagnosis
  • Esophagoscopy
  • Esophagus/blood supply
  • Feasibility Studies
  • Female
  • Gastrointestinal Hemorrhage/diagnosis
  • Humans
  • Liver Neoplasms/complications
  • Portal Vein/surgery
  • Recurrence
  • Secondary Prevention/instrumentation
  • Shock, Hemorrhagic/etiology
  • Stents
  • Tomography, X-Ray Computed
  • Treatment Outcome

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