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Look to the Left: A Rare Case of Recurrent Upper GI Bleeding

Abstract

Sven Pannach, Stefan Brückner, Florian Ehehalt and Jan Beyer Westendorf

We present the case of a 63 year old male who developed recurrent massive gastric varicose vein bleedingepisodes years after necrotising pancreatitis. Endoscopy revealed extensive gastric but no esophageal varices. Ultrasonographic findings included an enlarged spleen, normal portal vein diameter and flow and a regular liver texture without signs of cirrhosis. CT scan demonstrated massive perigastric and splenic collateral veins due to chronic splenic vein occlusion. Left-sided portal hypertension was diagnosed and the patient treated with splenectomy. In an endoscopic 2-year follow-up, gastric varicose veins have completely regressed and the patient has remained free of recurrent GI bleeding complications.

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