Medicine · 2017
Bleeding from isolated gastric varices as complication of a mucinous cystic neoplasm of the pancreas: A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Lupascu-Ursulescu Corina, Trofin Ana-Maria, Zabara Mihai, Vornicu Alexandra, Cadar Ramona, Apopei Oana, Stefanescu Gabriela, Lupascu Cristian
Аннотация
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.
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.