Refractory gastric variceal bleeding secondary to splenic vein occlusion associated with abdominal lymphadenopathy

ADVANCES IN DIGESTIVE MEDICINE - Tập 3 - Trang 195-199 - 2016
Yu-Chun Lin1, Yen-Bo Chen1, Po-Hao Liao1, Wen-Chi Chao2, Jiunn-Chang Lin3, Yu-Chung Hong4, Shen-Yung Wang1
1Division of Gastroenterology, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan
2Division of Chest Medicine, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan
3Department of Surgery, MacKay Memorial Hospital, Taipei, Taiwan
4Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan

Tóm tắt

SummarySplenic vein occlusion caused by abdominal lymphadenopathy is rare. We herein present the case of a 80‐year‐old man with refractory isolated gastric variceal bleeding in the absence of pancreatic or liver disease. Left‐sided portal hypertension was confirmed by angiography, and para‐aortic lymphadenopathy compressing the splenic vein was identified by serial abdominal computed tomography. Endoscopic sclerosing therapy failed to treat the recurring gastric variceal hemorrhage. Therefore, splenectomy was suggested and the patient was successfully treated. The patient had been variceal bleeding free for 12 months since the surgery. In patients with isolated gastric varices but without advanced liver disease, a variety of diagnostic techniques should be attempted to elucidate the nature of portal hypertension, and left‐sided portal hypertension should be suspected. For those cases in which endoscopic treatment failed to treat refractory gastric variceal bleeding, splenectomy can be an effective option.

Tài liệu tham khảo

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ADVANCES IN DIGESTIVE MEDICINE

Tập 3

195-199

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