Successful plug-assisted retrograde transvenous obliteration via the right gonadal vein for duodenal variceal bleeding from a mesocaval shunt

Duodenal variceal bleeding is a rare but potentially life-threatening complication of portal hypertension, frequently associated with abnormal portosystemic collateral pathways. We present a case of successful plug-assisted retrograde transvenous obliteration (PARTO) performed for duodenal varices d...

Full description

Saved in:
Bibliographic Details
Main Authors: Woo Jin Yang, Tae-Seok Seo, Myung Gyu Song
Format: Article
Language:English
Published: Society of Gastrointestinal Intervention 2025-07-01
Series:International Journal of Gastrointestinal Intervention
Subjects:
Online Access:https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii250032
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Duodenal variceal bleeding is a rare but potentially life-threatening complication of portal hypertension, frequently associated with abnormal portosystemic collateral pathways. We present a case of successful plug-assisted retrograde transvenous obliteration (PARTO) performed for duodenal varices draining into the right gonadal vein via a mesocaval shunt in a patient with hepatocellular carcinoma and liver cirrhosis. Despite severe angulation and tortuosity of the shunt, a strategic approach involving dual vascular plugs and gelfoam injection successfully achieved complete shunt obliteration without recurrence over a two-year follow-up period. This case underscores the feasibility of PARTO even in anatomically complex ectopic varices and suggests its applicability beyond traditionally described shunt anatomies.
ISSN:2636-0004