Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization: a case report | Paramythiotis et al. Journal of Medical Case Reports 2010 4 139 http content 4 1 139 jA CASE REPORTS CASE REPORT Open Access Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization a case report Daniel Paramythiotis 1 Theodossis S Papavramidis 1 Konstantinos Giavroglou2 Stamatia Potsi2 Fotis Girtovitis3 Antonis Michalopoulos1 Vassilis N Papadopoulos1 and John Prousalidis1 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. Introduction Massive gastrointestinal bleeding may result either from esophageal gastric varices or from portal hypertensive gastropathy. Sinistral portal hypertension SPH is a clinical syndrome of gastric variceal hemorrhage in the setting of splenic vein thrombosis SVT .
