Zhang TQ, Zhang L, Yong X, Tian C, Chen BJ, Qin JP, Mu D, Tang SH. Transjugular intrahepatic portosystemic shunt for variceal bleeding due to hereditary hemorrhagic telangiectasia with cirrhosis: A case report. World J Gastroenterol 2026; 32(12): 119002 [DOI: 10.3748/wjg.v32.i12.119002]
Corresponding Author of This Article
Shan-Hong Tang, MD, Doctor, Department of Gastroenterology, The General Hospital of Western Theater Command, No. 270 Rongdu Avenue, Jinniu District, Chengdu 610083, Sichuan Province, China. shanhongtang@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Tong-Qin Zhang, Dong Mu, Department of Gastroenterology and Hepatology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Liang Zhang, Xin Yong, Bei-Jin Chen, Jian-Ping Qin, Shan-Hong Tang, Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Chao Tian, Department of Radiology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Co-first authors: Tong-Qin Zhang and Liang Zhang.
Author contributions: Zhang TQ and Tang SH contributed to conceptualization; Yong X and Tian C contributed to methodology; Chen BJ and Qin JP contributed to validation and visualization; Zhang L and Zhang TQ contributed to software, formal analysis, data curation, writing original draft preparation; Zhang L and Mou D contributed to resources, writing review and editing, supervision; all authors have read and agreed to the published version of the manuscript.
Informed consent statement: Authors’ institution does not require ethical approval for publication of a single case report. Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Shan-Hong Tang, MD, Doctor, Department of Gastroenterology, The General Hospital of Western Theater Command, No. 270 Rongdu Avenue, Jinniu District, Chengdu 610083, Sichuan Province, China. shanhongtang@163.com
Received: January 20, 2026 Revised: February 5, 2026 Accepted: March 2, 2026 Published online: March 28, 2026 Processing time: 62 Days and 14.9 Hours
Abstract
BACKGROUND
The co-occurrence of hereditary hemorrhagic telangiectasia (HHT) and hepatitis C cirrhosis represents an exceptionally rare clinical entity, which can pose a diagnostic and therapeutic challenge.
CASE SUMMARY
We reported a patient with portal hypertension-induced esophageal and gastric variceal rupture due to HHT-hepatic arterioportal fistula and hepatitis C cirrhosis. Computed tomography confirmed hepatic diffuse arteriovenous fistula. Following initial embolization of arterioportal fistula, persistent gastrointestinal bleeding recurred, indicating suboptimal embolization efficacy. Subsequent transjugular intrahepatic portosystemic shunt (TIPS) treatment was performed and resulted in significant portal hypertension reduction. Endoscopic evaluation demonstrated marked improvement in esophageal and gastric varices, achieving remarkable therapeutic outcomes.
CONCLUSION
TIPS is an effective treatment option for esophageal and gastric variceal bleeding secondary to portal hypertension in patients with both HHT and liver cirrhosis.
Core Tip: Interventional embolization remains the first-line treatment for hepatic arterioportal fistula. However, when embolization fails to achieve hemostasis, transjugular intrahepatic portosystemic shunt (TIPS) may serve as an alternative therapeutic strategy. Herein, we report a female patient with liver cirrhosis and hereditary hemorrhagic telangiectasia who presented with recurrent bleeding and was successfully managed with TIPS.
