CLC number: R657.3+4
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2013-05-10
Cited: 0
Clicked: 5695
Zhi-yu Li, Bin Li, Yu-lian Wu, Qiu-ping Xie. Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review[J]. Journal of Zhejiang University Science B, 2013, 14(6): 549-554.
@article{title="Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review",
author="Zhi-yu Li, Bin Li, Yu-lian Wu, Qiu-ping Xie",
journal="Journal of Zhejiang University Science B",
volume="14",
number="6",
pages="549-554",
year="2013",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1200247"
}
%0 Journal Article
%T Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review
%A Zhi-yu Li
%A Bin Li
%A Yu-lian Wu
%A Qiu-ping Xie
%J Journal of Zhejiang University SCIENCE B
%V 14
%N 6
%P 549-554
%@ 1673-1581
%D 2013
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1200247
TY - JOUR
T1 - Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review
A1 - Zhi-yu Li
A1 - Bin Li
A1 - Yu-lian Wu
A1 - Qiu-ping Xie
J0 - Journal of Zhejiang University Science B
VL - 14
IS - 6
SP - 549
EP - 554
%@ 1673-1581
Y1 - 2013
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1200247
Abstract: left-sided portal hypertension (LSPH) followed by acute pancreatitis is a rare condition with most patients being asymptomatic. In cases where gastrointestinal (GI) bleeding is present, however, the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment. A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article. The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography (CT) scan and CT-angiography. After embolization, the bleeding stopped and stabilized for the entire follow-up period without any severe complications. In conclusion, embolization of the splenic artery is a simple, safe, and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.
[1]Balthazar, E.J., 2002. Complications of acute pancreatitis: clinical and CT evaluation. Radiol. Clin. North Am., 40(6):1211-1227.
[2]Bernades, P., Baetz, A., Lévy, P., Belghiti, J., Menu, Y., Fékété, F., 1992. Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical-surgical series of 266 patients. Dig. Dis. Sci., 37(3):340-346.
[3]Bradley, E.L., 1986. The natural history of splenic vein thrombosis due to chronic pancreatitis: indications for surgery. Int. J. Pancreatol., 2(2):87-92.
[4]Butler, J.R., Eckert, G.J., Zyromski, N.J., Leonardi, M.J., Lillemoe, K.D., Howard, T.J., 2011. Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB, 13(12):839-845.
[5]Evans, G.R., Yellin, A.E., Weaver, F.A., Stain, S.C., 1990. Sinistral (left-sided) portal hypertension. Am. Surg., 56(12):758-763.
[6]Flati, G., Andren-Sandberg, A., La Pinta, M., Porowska, B., Carboni, M., 2003. Potentially fatal bleeding in acute pancreatitis: pathophysiology, prevention, and treatment. Pancreas, 26(1):8-14.
[7]Gaba, R.C., Katz, J.R., Parvinian, A., Reich, S., Omene, B.O., Yap, F.Y., Owens, C.A., Knuttinen, M.G., Bui, J.T., 2013. Splenic artery embolization: a single center experience on the safety, efficacy, and clinical outcomes. Diagn. Interv. Radiol., 19(1):49-55.
[8]Heider, T.R., Azeem, S., Galanko, J.A., Behrns, K.E., 2004. The natural history of pancreatitis-induced splenic vein thrombosis. Ann. Surg., 239(6):876-880.
[9]Ito, K., Kudo, A., Nakamura, N., Tanaka, S., Teramoto, K., Arii, S., 2008. Left-sided portal hypertension caused by serous cystadenoma of the pancreas: report of a case. Surg. Today, 38(2):184-187.
[10]Johnston, F.R., Myers, R.T., 1973. Etiologic factors and consequences of splenic vein obstruction. Ann. Surg., 177(6):736-739.
[11]Keith, R.G., Mustard, R.A.Jr., Saibil, E.A., 1982. Gastric variceal bleeding due to occlusion of splenic vein in pancreatic disease. Can. J. Surg., 25(3):301-304.
[12]Kim, T., Shijo, H., Kokawa, H., Tokumitsu, H., Kubara, K., Ota, K., Akiyoshi, N., Iida, T., Yokoyama, M., Okumura, M., 1997. Risk factors for hemorrhage from gastric fundal varices. Hepatology, 25(2):307-312.
[13]Koconis, K.G., Singh, H., Soares, G., 2007. Partial splenic embolization in the treatment of patients with portal hypertension: a review of the English language literature. J. Vasc. Interv. Radiol., 18(4):463-481.
[14]Little, A.G., Moossa, A.R., 1981. Gastrointestinal hemorrhage from left-sided portal hypertension. An unappreciated complication of pancreatitis. Am. J. Surg., 141(1):153-158.
[15]Madsen, M.S., Petersen, T.H., Sommer, H., 1986. Segmental portal hypertension. Ann. Surg., 204(1):72-77.
[16]McCormick, P.A., O′Keefe, C., 2001. Improving prognosis following a first variceal haemorrhage over four decades. Gut, 49(5):682-685.
[17]Moossa, A.R., Gadd, M.A., 1985. Isolated splenic vein thrombosis. World J. Surg., 9(3):384-390.
[18]Ou, H.Y., Huang, T.L., Chen, T.Y., Tsang, L.L., Concejero, A.M., Chen, C.L., Cheng, Y.F., 2005. Emergency splenic arterial embolization for massive variceal bleeding in liver recipient with left-sided portal hypertension. Liver Transpl., 11(9):1136-1139.
[19]Petermann, A., Chabrot, P., Cassagnes, L., Dumousset, E., Alfidja, A., Gageanu, C., Ravel, A., Abergel, A., Boyer, L., 2012. Hypersplenism due to portal hypertension: retrospective evaluation of 17 patients treated by splenic embolization. Diagn. Interv. Imaging, 93(1):30-36.
[20]Sakorafas, G.H., Sarr, M.G., Farley, D.R., Farnell, M.B., 2000. The significance of sinistral portal hypertension complicating chronic pancreatitis. Am. J. Surg., 179(2):129-133.
[21]Shah, R., Mahour, G.H., Ford, E.G., Stanley, P., 1990. Partial splenic embolization. An effective alternative to splenectomy for hypersplenism. Am. Surg., 56(12):774-777.
[22]Stabile, B.E., Wilson, S.E., Debas, H.T., 1983. Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. Arch. Surg., 118(1):45-51.
[23]Weber, S.M., Rikkers, L.F., 2003. Splenic vein thrombosis and gastrointestinal bleeding in chronic pancreatitis. World J. Surg., 27(11):1271-1274.
Open peer comments: Debate/Discuss/Question/Opinion
<1>