Tang SH, Zeng WZ, He QW, Qin JP, Wu XL, Wang T, Wang Z, He X, Zhou XL, Fan QS, Jiang MD. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding: A case report and review. World J Clin Cases 2015; 3(10): 920-925 [PMID: 26488031 DOI: 10.12998/wjcc.v3.i10.920]
Corresponding Author of This Article
Dr. Wei-Zheng Zeng, Department of Digestion, General Hospital of Chengdu Military Command, No. 270 Tianhui Road, Chengdu 610083, Sichuan Province, China. 15928956390@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shan-Hong Tang, Wei-Zheng Zeng, Jian-Ping Qin, Xiao-Ling Wu, Zhao Wang, Xuan He, Xiao-Lei Zhou, Ming-De Jiang, Department of Digestion, General Hospital of Chengdu Military Command, Chengdu 610083, Sichuan Province, China
Shan-Hong Tang, Quan-Shui Fan, Center for Disease Prevention and Control of Chengdu Military Command, Chengdu 610083, Sichuan Province, China
Qian-Wen He, Department of Radiology, General Hospital of Chengdu Military Command, Chengdu 610083, Sichuan Province, China
Tao Wang, Department of General Surgery, General Hospital of Chengdu Military Command, Chengdu 610083, Sichuan Province, China
Author contributions: All authors contributed to this paper.
Supported by National Natural Science Foundation of China, No. 81401993 (to Tang SH).
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Wei-Zheng Zeng, Department of Digestion, General Hospital of Chengdu Military Command, No. 270 Tianhui Road, Chengdu 610083, Sichuan Province, China. 15928956390@163.com
Telephone: +86-4006996681
Received: March 27, 2015 Peer-review started: March 28, 2015 First decision: May 18, 2015 Revised: June 11, 2015 Accepted: September 2, 2015 Article in press: September 25, 2015 Published online: October 16, 2015 Processing time: 22 Days and 1.8 Hours
Abstract
Gastric varices (GV) are one of the most common complications for patients with portal hypertension. Currently, histoacryl injection is recommended as the initial treatment for bleeding of GV, and this injection has been confirmed to be highly effective for most patients in many studies. However, this treatment might be ineffective for some types of GV, such as splenic vein thrombosis-related localized portal hypertension (also called left-sided, sinistral, or regional portal hypertension). Herein, we report a case of repeated pancreatitis-induced complete splenic vein thrombosis that led to intractable gastric variceal bleeding, which was treated by splenectomy. We present detailed radiological and pathological data and blood rheology analysis (the splenic artery - after a short gastric vein or stomach vein - gastric coronary vein - portal vein). The pathophysiology can be explained by the abnormal direction of blood flow in this patient. To our knowledge, this is the first reported case for which detailed pathology and blood rheology data are available.
Core tip: Here, we report a case in which chronic pancreatitis-induced complete splenic vein thrombosis led to intractable gastric variceal bleeding, which is effectly treated by splenectomy. We have provided details regarding the imaging and pathology data, and we describe the hemodynamic characteristics. Then, we reviewed the disease onset and treatment methods, which may provide a reference for the clinical diagnosis and treatment of similar patients.
