Trans-splenic percutaneous glue embolization of bleeding gastric varices in the setting of malignant sinistral portal hypertension

Trans-splenic percutaneous glue embolization of bleeding gastric varices in the setting of malignant sinistral portal hypertension

Blog Article

Abstract Sinistral socialstudiesscholar.com portal hypertension, also known as left-sided portal hypertension, is a rare cause of gastric variceal bleeding which occurs secondary to occlusion of the splenic vein.We present a case of venous occlusion and sinistral portal hypertension secondary to distal pancreatic cancer requiring treatment of gastric variceal bleeding.After failing conservative management, transvenous intervention was attempted, but a venous communication with the gastric varices was unable to be identified on multiple venograms.A percutaneous trans-splenic approach using a 21-G needle and ultrasound guidance was successful in directly accessing an intraparenchymal vein nyx 22 brush feeding the gastric varices, and glue embolization was performed directly through the access needle with excellent results.