Oxaliplatin-Induced Hepatoportal Sclerosis, Portal Hypertension, and Variceal Bleeding Successfully Treated With Transjugular Intrahepatic Portosystemic Shunt

Oxaliplatin is commonly used for metastatic colon or rectal cancer. Side effects of oxaliplatin are well known and are predictable in terms of their onset and duration. Furthermore, oxaliplatin side effects are almost always reversible and will go away after treatment cessation. • Although studies have shown oxaliplatin to be associated with hepatic vascular injury, herein the authors describe a case of symptomatic portal hypertension, hepatoportal sclerosis, and variceal bleeding secondary to the use of oxaliplatin. The liver biopsy specimen revealed no signs of cirrhosis but did demonstrate evidence of hepatoportal sclerosis and vascular injury. The patient was successfully treated with a transjugular intrahepatic portosystemic shunt (TIPS) and remained in good health with no recurrence of symptoms at 3.5-years of follow-up. • Clinicians should be aware that rapid, acute, and symptomatic portal hypertension is a rare manifestation of the oxaliplatin chemotherapeutic regimen; furthermore, successful long-term treatment with TIPS is possible to manage the sequelae. © 2012 Elsevier Inc.