Idiopathic Splenic Vein Thrombosis Presenting as Splenic Infarction and Consequent Gastric Variceal Bleeding

Left-sided portal hypertension and consequent gastric varices can occur in patients with isolated splenic vein thrombosis. It is a rare but clinically significant and curable cause of gastrointestinal hemorrhage. Our patient, a 20-year-old woman, with left flank pain was diagnosed with having idiopathic splenic vein thrombosis with resultant splenic infarction. Thorough workups for the possible etiologies of splenic vein thrombosis were all negative. After six months of anticoagulation, follow-up computed tomography revealed formation of gastric varices; one month following the discovery, she developed gastrointestinal bleeding. Splenectomy was performed, resulting in the resolution of gastric varices.

The clinic and endoscopic features of left-sided portal hypertension / 中华消化内镜杂志

Objective To investigate the clinic and endosoopic features of left-sided portal hypertension ( LSPH). Methods Eight patients with left-sided portal hypertension were analyzed retrospectively. Results The main manifestations of patients with LSPH were hematemesis, hematochezia, splenomegaly and hypersplenism. The patients have the features of pancreatic disease, but without the evidences of hepatic disease. Solitary gastric varices account for 62. 5% , both gastric and esophageal varices account for 37. 5% . The patients with features of LSPH often mislead to diagnose as blood diseases or portal hypertension resulted from hepatic cirrhosis. Conclusions Pancreatic diseases may lead to portal hypertension, solitary gastric varices were the important evidence of left-sided portal hypertension.