Targeting the perforator vein: EUS-guided coil embolization for the treatment of bleeding rectal varices

A 71-year-old man with alcohol-induced cirrhosis, complicated by portal hypertension, esophageal and rectal varices, and chronic portal vein thrombosis, presented to the hospital with rectal bleeding. This was his fourth presentation over the past year, with multiple diagnostic colonoscopies revealing rectal varices as the source of the bleeding and no therapeutic interventions performed. He was hemodynamically stable with unremarkable physical examination findings. Laboratory results revealed hemoglobin of 9.6 g/dL, platelet count of 103 × 109/L, and international normalized ratio of 1.4.