Case Report
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World J Gastroenterol. Oct 21, 2014; 20(39): 14495-14499
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14495
Treatment of gastric varices with partial splenic embolization in a patient with portal vein thrombosis and a myeloproliferative disorder
Robert Gianotti, Hearns Charles, Kenneth Hymes, Hersh Chandarana, Samuel Sigal
Robert Gianotti, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States
Hearns Charles, Kenneth Hymes, Hersh Chandarana, Samuel Sigal, New York University School of Medicine, New York, NY 10022, United States
Author contributions: All the authors contributed to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.
Correspondence to: Robert Gianotti, MD, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Dana 501, Boston, MA 02215, United States. rgianott@bidmc.harvard.edu
Telephone: +1-617-6672136 Fax: +1-617-6672767
Received: June 4, 2013
Revised: September 30, 2013
Accepted: October 19, 2013
Published online: October 21, 2014
Processing time: 503 Days and 16.1 Hours
Abstract

Therapeutic options for gastric variceal bleeding in the presence of extensive portal vein thrombosis associated with a myeloproliferative disorder are limited. We report a case of a young woman who presented with gastric variceal bleeding secondary to extensive splanchnic venous thrombosis due to a Janus kinase 2 mutation associated myeloproliferative disorder that was managed effectively with partial splenic embolization.

Keywords: Gastric varices; Partial splenic embolization; Myeloproliferative disorder; Janus kinase 2, Portal hypertension; Portal vein thrombosis

Core tip: Non-cirrhotic portal hypertension is uncommon in the United States. The myeloproliferative disorders (MPD) are a common cause of portal vein thrombosis and non-cirrhotic portal hypertension. To our knowledge, this case represents the first report in the literature of bleeding gastric varices treated with partial splenic embolization in a patient with a MPD that could not undergo transjugular intrahepatic portosystemic shunt or balloon retrograde transvenous obliteration.