Massive Gastric Variceal Bleeding in a Patient with Chronic Pancreatitis
Left-sided portal hypertension (LSPH) is a rare form of portal hypertension that usually occurs
as a result of isolated obstruction and thrombosis of the splenic vein.
We present a case of a 45-year-old male patient with history of repetitive chronic
pancreatitis exacerbations, who was hospitalized because of the severe gastric variceal bleeding and hemorrhagic shock, developed as a complication of the splenic vein thrombosis and
Splenectomy is the treatment of choice, but in this case, because of the patient`s severe
general condition and significant risk of new surgical procedure (extensive fibrous adhesions
in abdomen), transcatheter embolization of the splenic artery was undertaken as the method of
Upper endoscopy was performed two weeks after embolization and it showed significantly reduced gastric varices, with no signs of bleeding, what brings us indirectly to a conclusion that the embolization significantly decreased pressure in the portal circulation.
Variceal bleeding is the final outcome of many events that start with increase of portal
blood pressure, development of varices and their progressive dilatation up to their rupture and
Variceal bleeding mostly occurs as a result of portal hypertension within liver cirrhosis, and it can occur from oesophageal varices, gastric varices or ectopic varices along digestive
Left-sided portal hypertension (LSPH) is a rare form of portal hypertension that usually occurs as a result of isolated obstruction and thrombosis of the splenic vein, and it can
cause bleeding from isolated gastric varices.
Gastro Open J. 2015; 1(3): 66-70. doi: 10.17140/GOJ-1-111