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Laparoscopic splenectomy for variceal bleeding with non-cirrhotic portal vein thrombosis: a case report.
Hepatogastroenterology. 2003 Mar-Apr; 50(50):574-6.H

Abstract

A 57-year-old man was referred to our hospital for treatment of refractory gastric bleeding from gastric varices secondary to portal vein thrombosis. The patient's liver function tests and coagulation profile were normal. The venous phase of the superior mesenteric arteriogram, on the other hand, showed superior mesenteric vein-portal vein occlusion with surrounding hepatopetal variceal collaterals. The venous phase of the splenic arteriogram additionally showed splenic vein occlusion and collateral vessels from the gastric and retroperitoneal regions flowing into a portal cavernous transformation. Gastroscopy confirmed that the patient had gastric varices in the cardia. We performed laparoscopic splenectomy to treat refractory gastric bleeding from varices and symptomatic hypersplenism. The postoperative course was uneventful; the patient's gastric varices were less prominent on follow-up gastroscopy and the hematologic profile returned to normal. Extrahepatic portal vein thrombosis is the leading cause of variceal hemorrhage in patients with healthy livers. There is a consensus in the literature that splenectomy alone is of minimal value in preventing variceal bleeding in portal vein thrombosis. Splenectomy is, however, indicated in cases in which the patient has hepatopetal collaterals from the mesenteric vein system and whose hemorrhagic gastric varices are related to splenic vein thrombosis as in our case.

Authors+Show Affiliations

Second Department of Surgery, Osaka City University Medical School, 1-4-3, Asahimachi, Abeno-ku, Osaka 545-8585, Japan. tsukamotot@msic.med.osaka-cu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12749276

Citation

Tsukamoto, Tadashi, et al. "Laparoscopic Splenectomy for Variceal Bleeding With Non-cirrhotic Portal Vein Thrombosis: a Case Report." Hepato-gastroenterology, vol. 50, no. 50, 2003, pp. 574-6.
Tsukamoto T, Ikuta T, Uenishi T, et al. Laparoscopic splenectomy for variceal bleeding with non-cirrhotic portal vein thrombosis: a case report. Hepatogastroenterology. 2003;50(50):574-6.
Tsukamoto, T., Ikuta, T., Uenishi, T., Shuto, T., Tanaka, H., Kubo, S., Hirohashi, K., & Kinoshita, H. (2003). Laparoscopic splenectomy for variceal bleeding with non-cirrhotic portal vein thrombosis: a case report. Hepato-gastroenterology, 50(50), 574-6.
Tsukamoto T, et al. Laparoscopic Splenectomy for Variceal Bleeding With Non-cirrhotic Portal Vein Thrombosis: a Case Report. Hepatogastroenterology. 2003 Mar-Apr;50(50):574-6. PubMed PMID: 12749276.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic splenectomy for variceal bleeding with non-cirrhotic portal vein thrombosis: a case report. AU - Tsukamoto,Tadashi, AU - Ikuta,Tsuyoshi, AU - Uenishi,Takahiro, AU - Shuto,Taichi, AU - Tanaka,Hiromu, AU - Kubo,Shoji, AU - Hirohashi,Kazuhiro, AU - Kinoshita,Hiroaki, PY - 2003/5/17/pubmed PY - 2003/8/27/medline PY - 2003/5/17/entrez SP - 574 EP - 6 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 50 IS - 50 N2 - A 57-year-old man was referred to our hospital for treatment of refractory gastric bleeding from gastric varices secondary to portal vein thrombosis. The patient's liver function tests and coagulation profile were normal. The venous phase of the superior mesenteric arteriogram, on the other hand, showed superior mesenteric vein-portal vein occlusion with surrounding hepatopetal variceal collaterals. The venous phase of the splenic arteriogram additionally showed splenic vein occlusion and collateral vessels from the gastric and retroperitoneal regions flowing into a portal cavernous transformation. Gastroscopy confirmed that the patient had gastric varices in the cardia. We performed laparoscopic splenectomy to treat refractory gastric bleeding from varices and symptomatic hypersplenism. The postoperative course was uneventful; the patient's gastric varices were less prominent on follow-up gastroscopy and the hematologic profile returned to normal. Extrahepatic portal vein thrombosis is the leading cause of variceal hemorrhage in patients with healthy livers. There is a consensus in the literature that splenectomy alone is of minimal value in preventing variceal bleeding in portal vein thrombosis. Splenectomy is, however, indicated in cases in which the patient has hepatopetal collaterals from the mesenteric vein system and whose hemorrhagic gastric varices are related to splenic vein thrombosis as in our case. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/12749276/Laparoscopic_splenectomy_for_variceal_bleeding_with_non_cirrhotic_portal_vein_thrombosis:_a_case_report_ L2 - http://www.diseaseinfosearch.org/result/5884 DB - PRIME DP - Unbound Medicine ER -