Schmidt S C, Möller J, Bürgel N, Radke C, Beyer L, Marusch F
Department for Hepato-Pancreato-Biliary Surgery, Ernst von Bergmann Clinic, Potsdam, Germany.
Department for Gastroenterology and Infectiology, Ernst von Bergmann Clinic, Potsdam, Germany.
J Surg Case Rep. 2021 Feb 11;2021(2):rjab008. doi: 10.1093/jscr/rjab008. eCollection 2021 Feb.
Upper gastrointestinal bleeding from esophagogastric varices is a common scenario, especially in patients with portal hypertension induced by liver cirrhosis or other diseases with thrombosis of the splenic vein. However, accessory spleen as pathophysiological cause of a regional, left-sided portal hypertension and consecutive development of isolated gastric varices is rare. We report a case of recurrent gastric variceal bleeding resulting from sinistral portal hypertension associated with an accessory spleen in a patient who had traumatic splenectomy many decades before. The accessory spleen is an extremely rare cause for the development of regional, left-sided portal hypertension leading to isolated gastric varices. Minimally invasive splenectomy is a safe and efficient treatment option.
食管胃静脉曲张引起的上消化道出血是一种常见情况，尤其是在肝硬化或其他导致脾静脉血栓形成的疾病引起门静脉高压的患者中。然而，副脾作为区域性左侧门静脉高压及随后孤立性胃静脉曲张形成的病理生理原因较为罕见。我们报告一例几十年前接受过外伤性脾切除术的患者，因与副脾相关的左侧门静脉高压导致复发性胃静脉曲张出血。副脾是导致区域性左侧门静脉高压并进而引发孤立性胃静脉曲张的极其罕见的原因。微创脾切除术是一种安全有效的治疗选择。
