Management of Rare Hemorrhage From Collateral Vessels During Gastrostomy Replacement Using Percutaneous Transhepatic Occlusion in Patient With Portal Hypertension

A 51-year-old male patient with alcoholic cirrhosis visited our hospital for a scheduled gastrostomy replacement. During the gastrostomy replacement, he suddenly experienced a massive hemorrhage from the fistula site. Based on enhanced computed tomography findings, we concluded that collateral blood vessels from the left gastroepiploic vein had flowed into the varices near the gastrostomy as the main origin of the bleeding. The patient received treatment with percutaneous transhepatic occlusion for the varices, which halted blood flow to the varices. This case suggests the possibility of such a complication in patients with worsening portal hypertension and the effectiveness of percutaneous transhepatic occlusion treatment.