Left inferior phrenic arterial malformation mimicking gastric varices: A case report and review of literature

Table 1 Summary of reports about acute upper gastrointestinal bleeding due to the absence of splenic artery

Age/sex	Symptoms	GIE findings	Bleeding vessel	Splenic artery	Treatment	Rebleeding	Ref.
13/M	Hematemesis	-	Left gastric artery	Congenital SA absence	Ligation + Splenectomy	No	Durrans et al[22]
31/M	Hematemesis	Erosive gastritis and duodenitis with hemorrhagic gastritis	Left gastric artery or short gastric arteries	Congenital SA absence	Vagotomy + pyloroplasty + Splenectomy	Yes (Achieved hemostasis by partial gastrectomy)	Spriggs[19]
50/F	Dizziness and tarry stools	A bleeding vessel in the gastric mucosa	Variant left gastric artery	The absence of the SA	Endoscopic clipping	Yes (Achieved hemostasis by TAE)	Namikawa et al[11]
60/M	Hematemesis	Varicose-shaped submucosal vessels with a small erosion	Arterial cluster arising from the left gastric artery and left gastroepiploic artery	Complete SA thrombosis	Endoscopic clipping followed by TAE	No	Martino et al[12]
52/M	Hematemesis and cold sweats	Large amount of clotted blood	-	SA occlusion	-	Death	Arslan et al[30]
69/M	Recurrent UGIB	A varicose shaped submucosal vessel located at the funds of the stomach	Left gastric artery	Idiopathic SA thrombosis	Splenectomy + dissection of the arteries	No	von Trotha et al[13]
36/M	Dizziness and melena	3-mm polypoid lesion in the gastric body of the stomach on the lesser curve	-	SA occlusion	Splenectomy + partial gastric devascularization	No	Baron et al[20]
66/M	Melena and fatigue	A submucosal lesion consistent with a vascular malformation in the fundus of the stomach	A cluster of arterial vessels branching from the occluded splenic artery	SA occlusion	TAE	No	Mnatzakanian et al[15]
49/M	Massive hematemesis	Prominent submucosal variceal-like structure	Enlarged left gastric artery	Chronic occlusion of the mid-SA	TAE	Yes (Achieved hemostasis by Splenectomy + ligation of the artery)	Al-Balas et al[14]
68/F	Black stools	A tortuous, submucosal mass with an overlying red spot	Collateral vessels arose from the proximal splenic artery	Aneurysmectomy	Ligation + Splenectomy	No	Worthley et al[21]
57/M	Black stools and dizziness	A bleeding vessel with ulcerative lesions in the fundus	Left inferior phrenic artery	The absence of the SA	Endoscopic clipping + ECGI	Yes (Achieved hemostasis by TAE)	Our case

TAE: Transcatheter arterial embolization; ECGI: Endoscopic cyanoacrylate glue injection; SA: Splenic artery; M: Male; F: Female; UGIB: Upper gastrointestinal bleeding; GIE: Gastrointestinal endoscopy.