Saddekni Souheil, Abdel-Aal Ahmed Kamel, Oser Rachel F, Underwood Edgar, Bag Asim
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
Vasc Endovascular Surg. 2012 Aug;46(6):480-3. doi: 10.1177/1538574412449908. Epub 2012 Jun 4.
We report a case of extensive left gastric artery collaterals that were formed in the region of gastric fundus due to splenic artery occlusion and resulted in massive hematemesis. These collaterals were thought to be portosystemic collaterals related to portal hypertension during upper endoscopy study and single-phase venous computed tomography studies. The collaterals were treated by transcatheter endovascular coil embolization. Our case highlights the importance of recognizing and differentiating left gastric artery collaterals from gastric venous varices as a cause of hematemesis since the treatment approach for each condition is totally different. It also introduces the feasibility of percutaneous left gastric artery embolization as a treatment for this condition, without the need for surgical splenectomy and partial gastrectomy which have a higher mortality and morbidity.
我们报告一例因脾动脉闭塞在胃底区域形成广泛的胃左动脉侧支循环，导致大量呕血的病例。在上消化道内镜检查和单相静脉计算机断层扫描研究中，这些侧支循环被认为是与门静脉高压相关的门体侧支循环。通过经导管血管内弹簧圈栓塞术对这些侧支循环进行了治疗。我们的病例强调了识别和区分胃左动脉侧支循环与胃静脉曲张作为呕血原因的重要性，因为每种情况的治疗方法完全不同。它还介绍了经皮胃左动脉栓塞术作为这种疾病治疗方法的可行性，而无需进行死亡率和发病率较高的脾切除和部分胃切除术。
