Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 21, 2012; 18(31): 4228-4232
Published online Aug 21, 2012. doi: 10.3748/wjg.v18.i31.4228
Autoimmune pancreatitis complicated by gastric varices: A report of 3 cases
Norihiro Goto, Jun Mimura, Toshinao Itani, Motohito Hayashi, Yukari Shimada, Tomoaki Matsumori
Norihiro Goto, Jun Mimura, Toshinao Itani, Motohito Hayashi, Yukari Shimada, Tomoaki Matsumori, Department of Gastroenterology, Nishi-Kobe Medical Center, Hyogo 651-2273, Japan
Author contributions: Goto N and Mimura J designed the research study; Goto N, Mimura J, Itani T, Hayashi M, Shimada Y, and Matsumori T performed the esophagogastroduodenoscopies and clinical follow-ups; Goto N analyzed the data and wrote the manuscript.
Correspondence to: Norihiro Goto, MD, Department of Gastroenterology, Nishi-Kobe Medical Center, 5-7-1 Kojidai Nishi-ku, Kobe, Hyogo 651-2273, Japan. marshall_prs@nmc-kobe.org
Telephone: +81-78-9972200 Fax: +81-78-9972220
Received: January 22, 2012
Revised: April 17, 2012
Accepted: April 20, 2012
Published online: August 21, 2012
Abstract

We present three cases of autoimmune pancreatitis (AIP) complicated by gastric varices. Case 1: A 57-year-old man was diagnosed with AIP complicated by gastric varices and splenic vein obstruction. Splenomegaly was not detected at the time of the diagnosis. The AIP improved using steroid therapy, the splenic vein was reperfused, and the gastric varices disappeared; case 2: A 55-year-old man was diagnosed with AIP complicated by gastric varices, splenic vein obstruction, and splenomegaly. Although the AIP improved using steroid therapy, the gastric varices and splenic vein obstruction did not resolve; case 3: A 68-year-old man was diagnosed with AIP complicated by gastric varices, splenic vein obstruction, and splenomegaly. The gastric varices, splenic vein obstruction, and AIP did not improve using steroid therapy. These three cases suggest that gastric varices or splenic vein obstruction without splenomegaly may be an indication for steroid therapy in patients with AIP because the complications will likely become irreversible over time.

Keywords: Autoimmune; Pancreatitis; Gastric varices