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Open Access 01-12-2011 | Case report

Severe gastric variceal haemorrhage due to splenic artery thrombosis and consecutive arterial bypass

Authors: Klaus T von Trotha, Marcel Binnebösel, Son Truong, Florian F Behrendt, Hermann E Wasmuth, Ulf P Neumann, Marc Jansen

Published in: BMC Surgery | Issue 1/2011

Abstract

Background

Upper gastrointestinal haemorrhage is mainly caused by ulcers. Gastric varicosis due to portal hypertension can also be held responsible for upper gastrointestinal bleeding. Portal hypertension causes the development of a collateral circulation from the portal to the caval venous system resulting in development of oesophageal and gastric fundus varices. Those may also be held responsible for upper gastrointestinal haemorrhage.

Case presentation

In this study, we describe the case of a 69-year-old male with recurrent severe upper gastrointestinal bleeding caused by arterial submucosal collaterals due to idiopathic splenic artery thrombosis. The diagnosis was secured using endoscopic duplex ultrasound and angiography. The patient was successfully treated with a laparoscopic splenectomy and complete dissection of the short gastric arteries, resulting in the collapse of the submucosal arteries in the gastric wall. Follow-up gastroscopy was performed on the 12^th postoperative week and showed no signs of bleeding and a significant reduction in the arterial blood flow within the gastric wall. Subsequent follow-up after 6 months also showed no further gastrointestinal bleeding as well as subjective good quality of life for the patient.

Conclusion

Submucosal arterial collaterals must be excluded by endosonography via endoscopy in case of recurrent upper gastrointestinal bleeding. Laparoscopic splenectomy provides adequate treatment in preventing any recurrent bleeding, if gastric arterial collaterals are caused by splenic artery thrombosis.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2482/11/14/prepub

Title: Severe gastric variceal haemorrhage due to splenic artery thrombosis and consecutive arterial bypass
Authors: Klaus T von Trotha
Marcel Binnebösel
Son Truong
Florian F Behrendt
Hermann E Wasmuth
Ulf P Neumann
Marc Jansen
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2011
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/1471-2482-11-14

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe gastric variceal haemorrhage due to splenic artery thrombosis and consecutive arterial bypass

Abstract

Background

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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