Acute colonic variceal bleeding treated with coil-assisted retrograde transvenous obliteration following atezolizumab–bevacizumab therapy for advanced hepatocellular carcinoma

Rationale

Colonic variceal bleeding is a rare but potentially life-threatening manifestation of portal hypertension. Bevacizumab therapy is associated with an increased risk of variceal bleeding, but bleeding from ectopic varices is less well recognized. Patient concerns: A 66-year-old man with alcohol-related cirrhosis and advanced hepatocellular carcinoma developed hematochezia on the day following the initiation of atezolizumab plus bevacizumab therapy. Diagnoses: Acute ascending colonic variceal bleeding in the setting of portal hypertension and portal vein thrombosis.