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  • Title: Plug-assisted retrograde transvenous obliteration via gastrocaval shunt for the gastric variceal bleeding: A case report.
    Author: Jang JY, Jeon UB, Kim JH, Kim TU, Ryu H, Cho M, Hong YM, Yoon KT.
    Journal: Medicine (Baltimore); 2021 Dec 10; 100(49):e28107. PubMed ID: 34889266.
    Abstract:
    RATIONALE: Most gastric varices at the fundus drain into the left renal vein via the gastrorenal shunt (80-85% of cases) or the inferior vena cava via the gastrocaval shunt (10-15%). Therefore, plug-assisted retrograde transvenous obliteration (PARTO) is usually performed via a gastrorenal shunt. Here, we report a case of gastric varix treated with PARTO via a gastrocaval shunt. PATIENT CONCERNS: A 46-year-old woman with hepatitis B virus and liver cirrhosis visited the emergency room in our hospital with the main symptom of hematemesis and hematochezia. DIAGNOSES: Endoscopy and computed tomography (CT) revealed a gastric varix and thrombotic-occluded transjugular intrahepatic portosystemic shunt (TIPS) stent. INTERVENTIONS: The patient underwent PARTO via a gastrocaval shunt to manage gastric variceal bleeding after failed TIPS revision. OUTCOMES: On CT, the gastric varix completely disappeared. The patient did not experience any additional bleeding events. LESSONS: PARTO via a gastrocaval shunt is safe and effective.
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