CASE REPORT article
Front. Med.
Sec. Hepatobiliary Diseases
Oxaliplatin-induced porto-sinusoidal vascular disease manifesting as recurrent gastroesophageal variceal hemorrhage: a case report
Ruiqi Zhao
Chang Liang
Zhuoqing Zhuang
Yuan Xia
Junzhu Lu
Yan Zhang
West China Hospital, Sichuan University, Chengdu, China
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Abstract
Abstract Porto-sinusoidal vascular disease (PSVD) is an increasingly recognized cause of non-cirrhotic portal hypertension, characterized by structural abnormalities of the portal microvasculature and hepatic sinusoids in the absence of cirrhosis. Recognized predis-posing factors include immune-mediated conditions, infections and exposure to hepatic sinusoid-toxic agents, among others. We report a 44-year-old woman with a history of oxaliplatin-based chemotherapy for colon cancer who presented with recurrent hematochezia, hematemesis, and transient encephalopathy. Evaluation demonstrated portal hypertension and portal vein thrombosis; however, liver biopsy showed no cirrhosis and the hepatic venous pressure gradient (HVPG) was within normal limits. Her medication history, combined with these findings, confirmed the diagnosis of oxaliplatin-induced PSVD. This case highlights the importance of considering PSVD in patients with non-cirrhotic portal hypertension, particularly when there is a history of exposure to agents toxic to the hepatic sinusoids, such as oxaliplatin.
Summary
Keywords
Hematemesis, Hematochezia, Non-cirrhotic portal hypertension, oxaliplatin, Porto-sinusoidal vascular disease, Thrombosis
Received
21 December 2025
Accepted
11 February 2026
Copyright
© 2026 Zhao, Liang, Zhuang, Xia, Lu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yan Zhang
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