Vaginal bleeding complicating portal hypertension: a particular entity – Report of two cases and review of the literature


Prof. Jan P. Lerut MD, PhD, FACS, Unit Liver Transplantation and General Surgery, Cliniques Universitaires St-Luc – STARZL Room, Université catholique de Louvain – UCL, 10 Avenue Hippocrates, B – 1200 Brussels, Belgium. Tel.: +32 2 7645306; fax: +32 2 7649039; e-mail:


Vaginal haemorrhage arising from varices is an exceptional complication of portal hypertension. Two cases successfully treated by transjugular intrahepatic portosystemic stent shunt are presented here. Both these patients previously had a total hysterectomy as did three out of four cases reported in the literature. Clinicians should be aware of ‘vaginal bleeding’ in the context of both hysterectomy and chronic liver disease in order to adopt the correct diagnostic and therapeutic approach. Definitive treatment can be obtained only if the underlying portal hypertension is adequately taken into consideration.