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The first case is that of a 60−year−old man with alcoholic liver disease who present− ed with refractory esophageal variceal bleeding. A TIPSS procedure was success− fully performed followed by coil emboli− zation of the left gastric vein. A subse− quent surveillance TIPSS check revealed that the shunt was occluded, and the pa− tient was entered into a variceal banding programme as patency of the TIPSS could not be restored. At endoscopy, two embo− lization coils were seen emerging from gastric fundal varices, with no stigmata of recent haemorrhage (Figure 1). The coils were left in situ, and the patient was discharged without complication.

Gastric Wall Invasion Following Transjugular Intrahepatic Portosystemic Stent Shunt Insertion for Variceal Bleeding