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 contribution | Haematemesis due to splenic vein thrombosis |
|---|---|
| Original language | Dutch |
| Pages (from-to) | A4992 |
| Journal | Nederlands Tijdschrift voor Geneeskunde |
| Volume | 156 |
| Issue number | 34 |
| Publication status | Published - 2012 |
Keywords
- Adult
- Gastroscopy
- Hematemesis/diagnosis
- Humans
- Male
- Spleen/blood supply
- Splenectomy
- Splenic Vein/pathology
- Treatment Outcome
- Venous Thrombosis/complications
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