scholarly journals Successful Treatment of Bleeding Gastric Varices with Splenectomy in a Patient with Splenic, Portal, and Mesenteric Thromboses

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Lior Menasherian-Yaccobe ◽  
Nathan T. Jaqua ◽  
Patrick Kenny
Keyword(s):  
Portal Hypertension ◽  
Successful Treatment ◽  
Splenic Vein ◽  
Gastric Varices ◽  
Variceal Hemorrhage ◽  
Splenic Vein Thrombosis ◽  
Packed Red Blood Cells ◽  
Vein Thrombosis ◽  
Shunt Procedure ◽  
Gastric Variceal Hemorrhage

A 59-year-old female with a history of multiple splanchnic and portal thromboses treated with warfarin underwent an esophagogastroduodenoscopy for cancer screening, and a polypoid mass was biopsied. One week later, she was admitted with upper gastrointestinal hemorrhage. Her therapeutic coagulopathy was reversed with fresh frozen plasma, and she was transfused with packed red blood cells. An esophagogastroduodenoscopy demonstrated an erosion of a gastric varix without evidence of recent bleeding. Conservative measures failed, and she continued to bleed during her stay. She was not considered a candidate for a shunt procedure; therefore, a splenectomy was performed. Postoperative esophagogastroduodenoscopy demonstrated near complete resolution of gastric varices. One year after discharge on warfarin, there has been no recurrence of hemorrhage. Gastric varices often arise from either portal hypertension or splenic vein thrombosis. Treatment of gastric variceal hemorrhage can be challenging. Transjugular intrahepatic portosystemic shunt is often effective for emergency control in varices secondary to portal hypertension. Splenectomy is the treatment for varices that arise from splenic vein thrombosis. However, treatment of gastric variceal hemorrhage in the context of multiple splanchnic and portal vein thromboses is more complicated. We report splenectomy as a successful treatment of gastric varices in a patient with multiple extrahepatic thromboses.

scholarly journals Gastric Varices in Absence of Splenic Vein Thrombosis: A Rare Entity of Idiopathic Non-Cirrhotic Portal Hypertension

Cureus ◽  
2017 ◽  
Author(s):  
Vivek Choksi ◽  
Binna Chokshi ◽  
Andrew Chu ◽  
Deepa Mandale ◽  
Daniel L Wolfson ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Splenic Vein ◽  
Gastric Varices ◽  
Rare Entity ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

Nonfunctioning Pancreatic Endocrine Tumor Presenting with Hemorrhage from Isolated Gastric Varices

2005 ◽  
Vol 71 (12) ◽  
pp. 1027-1030 ◽  
Author(s):  
Tetsuya Yamaguchi ◽  
Hiroshi Takahashi ◽  
Ryuzaburo Kagawa ◽  
Ryoji Takeda ◽  
Shingo Sakata ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Splenic Vein ◽  
Endocrine Tumor ◽  
Gastric Varices ◽  
Pancreatic Endocrine Tumor ◽  
Variceal Hemorrhage ◽  
Vein Occlusion ◽  
Splenic Vein Occlusion ◽  
Isolated Gastric Varices ◽  
Gastric Variceal Hemorrhage

Hemorrhage from gastric varices due to left-sided portal hypertension is an unusual presentation for pancreatic endocrine tumor. A case of pancreatic endocrine tumor presenting with gastric variceal hemorrhage secondary to left-sided portal hypertension associated with splenic vein occlusion is presented. A 53-year-old man with hemorrhage from isolated gastric varices was referred to our hospital. Laboratory studies revealed normal liver function. Surveys to identify the cause of gastric varices by an abdominal CT, MRCP, and abdominal angiography revealed splenic vein occlusion secondarily attributed to the pancreatic tail tumor and splenomegaly. The pancreatic tumor was suspected to be a resectable endocrine tumor. A distal pancreatectomy, splenectomy, partial resection of the gastric fundus, and limited lymph node dissection were performed. By the histological examination, the diagnosis of nonfunctioning pancreatic endocrine tumor with malignant potential was determined. Three years after the surgery, the patient is doing well and reveals no sign of recurrence. In this case, the unusual presentation for pancreatic endocrine tumors such as a gastric variceal hemorrhage had an advantage that led to early presentation prior to the development of metastases with possible curative surgery.

scholarly journals A73 PHARYNGEAL VARICES AS A COMPLICATION OF PORTAL HYPERTENSION: A CASE SERIES

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 86-88
Author(s):  
J Ghaith ◽  
P James ◽  
F Wong
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Splenic Vein ◽  
Case Series ◽  
Brachiocephalic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Ectopic Varices ◽  
Collateral Vessels

Abstract Background One of the complications of portal hypertension, with or without the presence of cirrhosis, is the development of varices along the length of the gastrointestinal tract. The commonest sites are along the esophagus or in the stomach. Ectopic varices in the small and large bowels can also be observed, but ectopic varices in the pharynx are extremely uncommon. Aims To present a case series and review the literature regarding pharyngeal varcies. Methods - Results Three elderly female patients presented for esophagogastric varices surveillance gastroscopy were diagnosed with pharyngeal varices. One patient has hepatitis C cirrhosis, while the other two non-cirrhotic patients have myeloproliferative neoplasm (MPN). None of the patients had thromboses of the portal vein or its tributaries. All three patient have concomitant esophageal varices, but only one required band ligation of her esophageal varices. All patients are asymptotic except for mild dysphagia. No patient has bled from their pharyngeal varices to date. Two patients have had prophylactic treatment of their portal hypertension with non-selective beta blocker (NSBB), while the third one has not received NSBB prophylaxis because of her age. Conclusions Pharyngeal varices are extremely rare. To date, there are three case reports in the literature, however, we have been able to identify three cases in our practice. The previous two cases reported possible left-sided portal hypertension with splenic vein thrombosis, leading to the development of collateral vessels including a gastrocaval shunt, which by some contiguous route connects to the brachiocephalic vein; and a third case was a complication of neck dissection surgery. In our case series, none of our patients had splenic vein thrombosis. However, none of them has had a careful CT angiogram to delineate the portal vein tributaries and the collateral vessels, which may further help to define their pathogenesis. It is unclear whether NSBB would be effective as primary prophylaxis against their bleeding, The plan is to continue to monitor these patients to learn about the natural history of these pharyngeal varices. Funding Agencies None

A Case of Portal and Splenic Vein Thrombosis After Histoacryl Injection Therapy in Gastric Varices

Endoscopy ◽  
1996 ◽  
Vol 28 (05) ◽  
pp. 461-461 ◽  
Author(s):  
C. S. Shim ◽  
Y. D. Cho ◽  
J. O. Kim ◽  
H. K. Bong ◽  
Y. S. Kim ◽  
...  
Keyword(s):  
Splenic Vein ◽  
Gastric Varices ◽  
Injection Therapy ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis
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