Refractory Esophageal Varices Requiring Transjugular Intrahepatic Portosystemic Shunt Placement in Oxaliplatin-Induced Portosinusoidal Vascular Disorder

Colorectal carcinoma is a leading cause of cancer-related mortality in the United States. Capecitabine and oxaliplatin, a standard first-line chemotherapy regimen contains oxaliplatin, which rarely causes sinusoidal injury leading to portosinusoidal vascular disorder (PSVD). We report a rare case of oxaliplatin-associated PSVD presenting with esophageal varices refractory to banding, ultimately requiring transjugular intrahepatic portosystemic shunt placement with variceal embolization. With few similar cases reported in the literature and in the absence of guidelines on managing refractory esophageal varices in PSVD, this case demonstrates a successful outcome with transjugular intrahepatic portosystemic shunt placement.