Advertisement

Gastrointestinal Radiology

, Volume 15, Issue 1, pp 188–192 | Cite as

Isolated gastric varices: Splenic vein obstruction or portal hypertension?

  • Marc S. Levine
  • Kim Kieu
  • Stephen E. Rubesin
  • Hans Herlinger
  • Igor Laufer
Article

Abstract

The presence of isolated gastric varices without esophageal varices is thought to be highly suggestive of splenic vein obstruction. A review of our radiologic files revealed 14 patients with isolated gastric varices on barium studies performed during the past 10 years. Eight of the 14 patients had adequate clinical and/or radiologic follow-up to suggest the pathophysiology of the varices. Seven had evidence of portal hypertension, and the remaining patient had evidence of splenic vein obstruction. Six patients had signs of upper gastrointestinal (GI) bleeding. Double-contrast upper GI examinations revealed thickened, tortuous fundal folds in 6 patients and a lobulated fundal mass in 2. Thus, most patients with isolated gastric varices have portal hypertension rather than splenic vein obstruction as the underlying cause.

Key words

Stomach, varices Portal hypertension, diagnosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Marshall JP, Smith PD, Hoyumpa AM: Gastric varices: problems in diagnosis.Am J Dig Dis 22:947–955, 1977Google Scholar
  2. 2.
    Itzchak Y, Glickman MG: Splenic vein thrombosis in patients with a normal size spleen.Invest Radiol 12:158–163, 1977Google Scholar
  3. 3.
    Cho KJ, Martel W: Recognition of splenic vein occlusion.AJR 131:439–443, 1978Google Scholar
  4. 4.
    Muhletaler C, Gerlock J, Goncharenko V, et al: Gastric varices secondary to splenic vein occlusion: radiographic diagnosis and clinical significance.Radiology 132:593–598, 1979Google Scholar
  5. 5.
    Marks LJ, Weingarten B, Gerst GR: Carcinoma of the tail of the pancreas associated with bleeding gastric varices and hypersplenism.Ann Intern Med 37:1077–1084, 1952Google Scholar
  6. 6.
    Sutton JP, Yarborough DY, Richards JT: Isolated splenic vein occlusion.Arch Surg 100:623–626, 1970Google Scholar
  7. 7.
    Salam AA, Warren WD, Tyras DH: Splenic vein thrombosis: a diagnosable and curable form of portal hypertension.Surgery 74:961–972, 1973Google Scholar
  8. 8.
    Karr S, Wohl GT: Clinical importance of gastric varices.N Engl J Med 263:665–669, 1960Google Scholar
  9. 9.
    Rice RP, Thompson WM, Kelvin FM, et al: Gastric varices without esophageal varices: an important preendoscopic diagnosis.JAMA 237:1976–1979, 1977Google Scholar
  10. 10.
    Okuda K, Yasumoto M, Goto A, Kunisaki T: Endoscopic observations of gastric varices.Am J Gastroenterol 60:357–365, 1973Google Scholar
  11. 11.
    Anderson MF, Dunnick NR: Pseudotumor caused by gastric varices.Am J Dig Dis 22:929–932, 1977Google Scholar
  12. 12.
    Belgrad R, Carlson HC, Payne WS, Cain JC: Pseudotumoral gastric varices.AJR 91:751–756, 1964Google Scholar
  13. 13.
    Kaye JJ, Stassa G: Mimicry and deception in the diagnosis of tumors of the gastric cardia.AJR 110:295–303, 1970Google Scholar
  14. 14.
    Hershfield NB, Morrow I: Gastric bleeding due to splenic vein thrombosis.Can Med Assoc J 98:649–652, 1968Google Scholar
  15. 15.
    Goldstein GB: Splenic vein thrombosis causing gastric varices and bleeding.Am J Gastroenterol 58:319–325, 1972Google Scholar
  16. 16.
    Babb RR: Splenic vein obstruction: a curable cause of variceal bleeding.Am J Dig Dis 21:512–513, 1976Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1990

Authors and Affiliations

  • Marc S. Levine
    • 1
  • Kim Kieu
    • 1
  • Stephen E. Rubesin
    • 1
  • Hans Herlinger
    • 1
  • Igor Laufer
    • 1
  1. 1.Department of RadiologyHospital of the University of PennsylvaniaPhiladelphiaUSA

Personalised recommendations