Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding: A case report and review

作     者：Shan-Hong Tang Wei-Zheng Zeng Qian-Wen He Jian-Ping Qin Xiao-Ling Wu Tao Wang Zhao Wang Xuan He Xiao-Lei Zhou Quan-Shui Fan Ming-De Jiang 

作者机构：Department of DigestionGeneral Hospital of Chengdu Military Command Center for Disease Preven-tion and Control of Chengdu Military Command Department of Radiology General Hospital of Chengdu Military Command Department of General Surgery General Hospital of Chengdu Military Command 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2015年第3卷第10期

页      面：920-925页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by National Natural Science Foundation of China No.81401993(to Tang SH) 

主　　题：Splenic vein thrombosis Intractable gastric variceal bleeding Recurrent pancreatitis Review 

摘      要：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 patho-logy and blood rheology data are available.