Fundusvarices als zeldzame oorzaak van hematemesis

Translated title of the contribution: Haematemesis due to splenic vein thrombosis

Young Kon Lambeck*, H. L.Erik van Westreenen, Bas L.A.M. Weusten, Robin Timmer, Djamila Boerma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Haematemesis due to gastric fundal varices as a result of splenic vein thrombosis is rare. Splenic vein thrombosis may occur after pancreatitis and can lead to left-sided portal hypertension. Venous drainage from the spleen then occurs through the short gastric vessels, resulting in gastric varices.

CASE DESCRIPTION: Gastroscopy was performed in a 31-year-old man for transgastric drainage of fluid which had accumulated after an episode of acute pancreatitis. A gastric blood clot and fundal varices were observed. Three days later, the patient experienced haematemesis and went into a state of shock. Gastroscopy showed a bleeding fundal varix which was treated by an injection of Lipiodol/Histoacryl. CT confirmed thrombosis of the splenic vein. Six weeks later, splenectomy was performed and no subsequent bleeding occurred.

CONCLUSION: Haematemesis in patients with a history of chronic or acute pancreatitis can be a life-threatening expression of gastric fundal varices caused by splenic vein thrombosis. In cases of severe haemorrhaging, splenectomy is the treatment of choice.

Translated title of the contributionHaematemesis due to splenic vein thrombosis
Original languageDutch
Pages (from-to)A4992
JournalNederlands Tijdschrift voor Geneeskunde
Volume156
Issue number34
Publication statusPublished - 2012

Keywords

  • Adult
  • Gastroscopy
  • Hematemesis/diagnosis
  • Humans
  • Male
  • Spleen/blood supply
  • Splenectomy
  • Splenic Vein/pathology
  • Treatment Outcome
  • Venous Thrombosis/complications

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