Endovascular management of rectal variceal bleeding in patients with cirrhosis and portal hypertension

Liver cirrhosis is one of the factors in the development of portal hypertension. Portal hypertension leads to dilation of collateral portosystemic veins along the gastrointestinal tract. The most common and serious complication of portal hypertension is varicose veins of the esophagus and bleeding from them. Less known, but no less dangerous, is bleeding from varicose veins of the lower gastrointestinal tract. The incidence of varicose veins occurs in 38-56% of patients with liver cirrhosis. Confirming the diagnosis is often difficult, and bleeding is sometimes massive. It can be life-threatening if not clearly diagnosed and treated promptly. Unlike the treatment of gastric and esophageal varices, there is currently no definitive recomended treatment due to insufficient data and rarity. In this article, we report the case of a 78-year-old woman with liver cirrhosis and rectal variceal bleeding which was refractory to medical and endoscopic therapy and successfully treated with transjugular intrahepatic portosystemic shunting (TIPS).