Gastric variceal bleeding due to occlusion of splenic vein in pancreatic disease.

Nine patients with gastric varices secondary to occlusion of the splenic vein, which resulted from pancreatic disease, were treated by the authors between 1973 and 1981. Profuse hemorrhage, recurrent bleeding and hypochromic anemia were investigated by endoscopy, gastrointestinal roentgenography and selective angiography. Pancreatic disease was defined by ultrasonography, endoscopic retrograde pancreatography and operation. There were three cases of chronic pancreatitis, three of pancreatic abscess, two of pseudocyst and one of carcinoma of the pancreas. Definitive control of upper gastrointestinal bleeding from gastric varices was achieved by combining splenectomy with selective pancreatic surgical procedures. Two patients did not undergo operation. One death resulted from an unresectable carcinoma. Bleeding did not recur in six patients followed for up to 8 years after operation.