Prolonged Radiation-Induced Gastritis Following Yttrium-90 Radioembolization: A Case of Persistent Dyspepsia and Endoscopic Surveillance

Yttrium-90 (Y-90) transarterial radioembolization (TARE) is an established therapy for unresectable hepatic malignancies. Although generally safe, Y-90 therapy can occasionally lead to extrahepatic complications, including gastrointestinal injury. Here, we present a case of delayed-onset Y-90-induced gastritis in a 72-year-old woman with intrahepatic cholangiocarcinoma. Following Y-90 radioembolization, the patient developed delayed gastrointestinal symptoms. Subsequent endoscopy revealed erythematous gastric mucosa with erosions, and biopsy showed intravascular microspheres consistent with radiation injury. Her symptoms improved with vonoprazan therapy and supportive management. This case thus illustrates delayed gastrointestinal toxicity as a rare complication of hepatic radioembolization.