Isolated gastric varices resulting from iatrogenic splenic vein occlusion: report of a case

Surg Today. 2003;33(7):542-4. doi: 10.1007/s10595-002-2519-7.

Abstract

Iatrogenic splenic vein occlusion is known to be a rare cause of left-sided portal hypertension. We herein describe the clinical course of a 43-year-old woman with isolated gastric varices, which proved to be attributable to a segmental splenic vein resection during an operation for a benign pancreatic tumor 11 years previously. Seven years after the initial operation, prominent gastric varices due to left-sided portal hypertension were first noted. During the follow-up period of 4 years, she had no episodes of gastrointestinal hemorrhaging. Although the size of the gastric varices did not change, she decided to have a splenectomy considering the potential risk of variceal hemorrhaging. It may be reasonable to perform a splenectomy concomitantly when the splenic vein is to be resected or ligated during pancreatic surgery to avoid the future development of left-sided portal hypertension. However, the role of prophylactic surgery in asymptomatic patients with iatrogenic splenic vein occlusion remains to be determined.

Publication types

  • Case Reports

MeSH terms

  • Esophageal and Gastric Varices / etiology*
  • Female
  • Humans
  • Hypertension, Portal / etiology*
  • Iatrogenic Disease*
  • Middle Aged
  • Pancreatectomy
  • Postoperative Complications*
  • Splenic Vein / surgery*