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A case of complete resolution of gastric varices

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From Nature Reviews Gastroenterology & Hepatology

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Abstract

Background. A 49-year-old woman with hepatitis C and peptic ulcer disease presented to the emergency department after an onset of sudden massive hematemesis. She had a history of alcohol abuse, but denied any recent excessive drinking.

Investigations. Physical examination, laboratory investigations including complete blood cell counts and liver function tests, esophagogastroduodenoscopy, abdominal angiography and venography, CT scans of the abdomen and pelvis.

Diagnosis. Gastric variceal hemorrhage, severe portal hypertensive gastropathy, splenic vein thrombosis.

Management. Blood transfusion, splenic artery embolization and balloon-occluded retrograde transvenous obliteration of gastric varices. Immediate postprocedural CT scans of the abdomen, with repeat imaging 30 months later.

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Figure 1: Splenic angiograms from the case patient.
Figure 2: A selective splenorenal shunt as seen after venogram injection, and embolization in the case patient.
Figure 3: Postcontrast arterial phase CT scans of the patient.

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Acknowledgements

Written consent for publication was obtained from the patient.

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Authors and Affiliations

  1. Rush University Medical Center, Chicago, IL, USA

    Vanessa Tieu, George Behrens, Hector Ferral, Stanley M. Cohen & Joseph Ahn

Authors
  1. Vanessa Tieu
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  2. George Behrens
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  3. Hector Ferral
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  4. Stanley M. Cohen
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  5. Joseph Ahn
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Correspondence to Vanessa Tieu.

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The authors declare no competing financial interests.

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Tieu, V., Behrens, G., Ferral, H. et al. A case of complete resolution of gastric varices. Nat Rev Gastroenterol Hepatol 6, 618–622 (2009). https://doi.org/10.1038/nrgastro.2009.144

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