Porto-gastric fistula due to penetration of metallic coil into the stomach: a rare complication of endovascular treatment of gastric varices. A case report
Abstract
The authors report a rare complication of the endovascular treatment of gastric varices. The case of a 68-year-old female with liver cirrhosis due to hereditary haemochromatosis with uncontrolled gastric variceal bleeding as the first clinical symptom of portal hypertension is presented.
She underwent a successful urgent TIPS (transjugular intrahepatic portosystemic shunt). Large portosystemic collaterals were embolised by metaloid coils and n-butyl-2-cyanoacrylate during the procedure.
Despite adeqatue hepatic venous pressure gradient reduction, re-bleeding from gastric varices occurred afterwards. Bleeding was successfully treated by local acrylate glue application during endoscopy.
Control gastroscopy was performed without any sign of bleeding three weeks later, showing coil penetration into the gastric lumen. The coils were left in situ and patient was discharged without any sign of complications.
Eleven months later the coils separated out and only the scar was found at upper endoscopy.