Bleeding from isolated gastric varices as complication of a mucinous cystic neoplasm of the pancreas: A case report. Issue 47 (November 2017)

• Record Type: Journal Article
• Authors: Lupascu-Ursulescu, Corina; Trofin, Ana-Maria; Zabara, Mihai; Vornicu, Alexandra; Cadar, Ramona; Apopei, Oana; Stefanescu, Gabriela; Lupascu, Cristian
• Other Names: Huang. Lei section editor.
• Is Part Of: Medicine. Volume 96:Issue 47(2017)
• Publication Date: 2017-11
• Subjects: gastric varices -- hematemesis -- mucinous cystic neoplasm -- pancreas; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008775
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Introduction: Bleeding from isolated gastric varices, though uncommon, may be life threatening and may occur as a consequence of splenic vein thrombosis by tumoral compression and subsequent left-sided portal hypertension. Case overview: We report the case of a 37-year old woman, previously diagnosed with a benign pancreatic cyst, who presented with severe gastric variceal bleeding. Diagnosis, therapeutics interventions, and outcomes: Abdominal ultrasound (US) and computed-tomography (CT) revealed enlargement and changed morphology of the cystic tumor located on the body of the pancreas. Left-sided portal hypertension was disclosed resulting from splenic vein occlusion. Salvage left spleno-pancreatectomy with lymphadenectomy was undertaken with an excellent postoperative outcome. Histological analysis established the diagnosis of mucinous cystic neoplasm with foci of adenocarcinoma. Conclusion: Surgical treatment proved to be the election one, leading to a steady hemostasis, removal of the lesion, positive diagnosis, and resolution of the varices. Imaging follow-up of pancreatic cyst should also assess vascular patency to identify the patient at risk for gastric bleeding and to select patients who benefits from surgical resection.