Transjugular intrahepatic portosystemic shunt placement for symptomatic non- bleeding anorectal varices in nodular regenerative hyperplasia.

In this paper we present the case of a male 55-year old patient with known ulcerative colitis and nodular regenerative hyperplasia, a rare form of noncirrhotic portal hypertension. He presented four visits to the emergency department with rapidly progressive anal discomfort. After two weeks a transjugular intrahepatic portosystemic shunt was placed using the gun-sight technique with immediate relief of the unbearable anal pain and pressure. To our knowledge, this is the first case where transjugular intrahepatic portosystemic shunt placement is applied for non- bleeding, congestive anorectal varices.