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Gastric varices may also be found in patients with thrombosis of the splenic vein, into which the short gastric veins that drain the fundus of the stomach flow. The latter may be a complication of acute pancreatitis , pancreatic cancer , or other abdominal tumours, as well as hepatitis C .
The splenic vein can be affected by thrombosis, presenting some of the characteristics of portal vein thrombosis and portal hypertension but localized to part of the territory drained by the splenic vein. These include varices in the stomach wall due to hypertension in the short gastric veins and abdominal pain. This results in gastric varices ...
Patients with portal hypertensive gastropathy may experience bleeding from the stomach, which may uncommonly manifest itself in vomiting blood or melena; however, portal hypertension may cause several other more common sources of upper gastrointestinal bleeding, such as esophageal varices and gastric varices. On endoscopic evaluation of the ...
Splenopancreatic and gastric disconnection (SPGD) [ edit ] DSRS is typically done with splenopancreatic and gastric disconnection (ligation of the gastric veins and pancreatic veins (that drain into the portal vein ) and complete detachment of the splenic vein from the portal venous system ), as it improves the outcome.
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
Balloon-occluded retrograde transvenous obliteration (BRTO) is an endovascular procedure used for the treatment of gastric varices.When performing the procedure, an interventional radiologist accesses blood vessels using a catheter, inflates a balloon (e.g. balloon occlusion) and injects a substance into the variceal blood vessels that causes blockage of those vessels.
The management of ATE depends on the location and severity of the ischemia and the underlying etiology. The main goals of ATE management are to restore blood flow, prevent further thrombosis, and treat the underlying cause. The treatment options for ATE include antithrombotic therapy, revascularization procedures, and risk factor modification.
The inferior mesenteric vein connects in the majority of people on the splenic vein, but in some people, it is known to connect on the portal vein or the superior mesenteric vein. Roughly, the portal venous system corresponds to areas supplied by the celiac trunk , the superior mesenteric artery , and the inferior mesenteric artery .