Bleeding Gastric Varices from Liver Cirrhosis Complicated by Hepatocellular Carcinoma Treated by Balloon Occluded Retrograde Transvenous Occlusion Obliteration using Sodium Tetradecyl Sulphate foam in an Emergent Setting

Abstract

Balloon occluded retrograde transvenous occlusion of gastric varices is a well-described technique for treating gastric varices. However, the procedure is usually performed in an elective setting, with use of conscious sedation. We report of a case which we performed, using Sodium Tetradecyl Sulphate Foam, in a middle aged man presenting with acute upper gastrointestinal bleeding secondary to gastric varices from alcoholic liver cirrhosis, complicated by hepatocellular carcinoma, with portal vein thrombosis, in an emergent setting and without conscious sedation. There was good outcome, with successful arrest of the bleeding. We discuss the use of this technique, as well as review the literature.