Upper Gastrointestinal Tract - Bleeding (2 of 7)

Active pulsatile bleeding from a gastric fundic, varix was seen at endoscopy. Gastric Varices are much less common cause of variceal hemorrhage than esophageal ones; but are important to recognize as the source of bleeding because their management is different. When gastric varices are prominent and associated with minimal to absent esophageal varices, one must consider splecnic vein thrombosis as the etiology of the increased venous pressures. Angiography may verify this diagnosis. These patients are best treated with simple splecnectomy, which adequately decompresses their varices. Such patients have an excellent prognosis because of the lack of underlying liver disease. Splecnic vein thrombosis may occur as a complication of pancreatitis due to contiguous inflammation from the body and tail of the pancreas. Histoacryl (N-butyl-2-cyanocrylate) has been used in bleeding esophagogastric and ectopic varices.