Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 May 19:4:139.
doi: 10.1186/1752-1947-4-139.

Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization: a case report

Daniel Paramythiotis  1 , Theodossis S Papavramidis, Konstantinos Giavroglou, Stamatia Potsi, Fotis Girtovitis, Antonis Michalopoulos, Vassilis N Papadopoulos, John Prousalidis
Affiliations

Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization: a case report

Daniel Paramythiotis et al. J Med Case Rep. .

Abstract

Introduction: Splenic vein thrombosis results in localized portal hypertension called sinistral portal hypertension, which may also lead to massive upper gastrointestinal bleeding. Symptomatic sinistral portal hypertension is usually best treated by splenectomy, but interventional radiological techniques are safe and effective alternatives in the management of a massive hemorrhage, particularly in cases that have a high surgical risk.

Case presentation: We describe a 23-year-old Greek man with acute massive gastric variceal bleeding caused by splenic vein thrombosis due to a missing von Leiden factor, which was successfully managed with splenic arterial embolization.

Conclusions: Interventional radiological techniques are attractive alternatives for patients with a high surgical risk or in cases when the immediate surgical excision of the spleen is technically difficult. Additionally, surgery is not always successful because of the presence of numerous portal collaterals and adhesion. Splenic artery embolization is now emerging as a safe and effective alternative to surgery in the management of massive hemorrhage from gastric varices due to splenic vein thrombosis, which often occurs in patients with hypercoagulability.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Ultrasonography showing dilated splenic vein of our patient.
Figure 2
Figure 2
Computed tomography scan presenting an enlarged spleen.
Figure 3
Figure 3
Angiography showing catheterization and embolization of the splenic artery using Gianturco steel coils.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Singhal D, Kakodkar R, Soin AS, Gupta, Nundy S. Sinistral portal hypertension: a case report. JOP. 2006;7:670–673. - PubMed
    1. Trudeau W, Prindiville T. Endoscopic injection sclerosis in bleeding gastric varices. Gastrointest Endosc. 1986;32:264–268. doi: 10.1016/S0016-5107(86)71843-9. - DOI - PubMed
    1. Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatol. 1992;16:1343–1349. doi: 10.1002/hep.1840160607. - DOI - PubMed
    1. Hashizume M, Kitano S, Yamaga H, Koyanagi N, Sugimachi K. Endoscopic classification of gastric varices. Gastrointest Endosc. 1990;36:276–280. doi: 10.1016/S0016-5107(90)71023-1. - DOI - PubMed
    1. Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N, Yamashita K. The natural history of gastric varices. Hepatogastroenterol. 2002;49:1180–1182. - PubMed

LinkOut - more resources