# Oxaliplatin‐induced portal hypertension manifesting as portosystemic shunt: A case report and review of sinusoidal obstruction syndrome in gastric cancer

## TL;DR

A 77-year-old woman with gastric cancer developed a portosystemic shunt after oxaliplatin treatment, highlighting the need for monitoring this rare side effect.

## Contribution

This case report adds to the understanding of oxaliplatin-induced portal hypertension and its management in gastric cancer patients.

## Key findings

- Oxaliplatin treatment was associated with portal hypertension and a portosystemic shunt in a gastric cancer patient.
- Discontinuation of oxaliplatin did not resolve the shunt, which was successfully treated with balloon-occluded retrograde transvenous obliteration.
- The case emphasizes the importance of monitoring for this rare but serious complication in patients receiving oxaliplatin.

## Abstract

A 77‐year‐old woman with stage IVB gastric adenocarcinoma (cT4N2M1) received 10 cycles of S‐1, oxaliplatin, and nivolumab combination chemotherapy. Imaging and biopsy confirmed a complete response. However, thrombocytopenia, mild splenomegaly, and elevated liver enzymes developed following oxaliplatin administration. After the tenth cycle, a contrast‐enhanced computed tomography scan revealed a portosystemic shunt. Oxaliplatin was discontinued, but the shunt persisted after 1 year. Balloon‐occluded retrograde transvenous obliteration was successfully performed, resulting in the resolution of the shunt. This case highlights the potential for oxaliplatin‐induced portal hypertension requiring close monitoring.