Department of Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
J Zhejiang Univ Sci B. 2013 Jun;14(6):549-54. doi: 10.1631/jzus.B1200247.
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.
左侧门脉高压(LSPH)继发出血性胰腺炎是一种罕见的病症,大多数患者无症状。然而,在存在胃肠道(GI)出血的情况下,病情更为复杂,死亡率非常高,因为诊断和选择最佳治疗方法存在困难。本文报道了一例经导管脾动脉栓塞术成功治疗严重 GI 出血的病例。该患者表现为严重的不可控制的 GI 出血,并通过增强计算机断层扫描(CT)扫描和 CT 血管造影证实为 LSPH 继发的胃静脉曲张。栓塞后,出血停止并在整个随访期间稳定,无任何严重并发症。总之,脾动脉栓塞术是一种简单、安全、有效的方法,可控制急性胰腺炎继发 LSPH 引起的胃静脉曲张出血。