Related Experiment Video
Updated: May 19, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
[Haematemesis due to splenic vein thrombosis]
Young-Kon Lambeck1, H L Erik van Westreenen, Bas L A M Weusten
1Sint Antonius Ziekenhuis, Afd. Chirurgie, Nieuwegein, the Netherlands.
Background:
Haematemesis due to gastric fundal varices as a result of splenic vein thrombosis is rare. Splenic vein thrombosis may occur after pancreatitis and can lead to left-sided portal hypertension. Venous drainage from the spleen then occurs through the short gastric vessels, resulting in gastric varices.
Case Description:
Gastroscopy was performed in a 31-year-old man for transgastric drainage of fluid which had accumulated after an episode of acute pancreatitis. A gastric blood clot and fundal varices were observed. Three days later, the patient experienced haematemesis and went into a state of shock. Gastroscopy showed a bleeding fundal varix which was treated by an injection of Lipiodol/Histoacryl. CT confirmed thrombosis of the splenic vein. Six weeks later, splenectomy was performed and no subsequent bleeding occurred.
Conclusion:
Haematemesis in patients with a history of chronic or acute pancreatitis can be a life-threatening expression of gastric fundal varices caused by splenic vein thrombosis. In cases of severe haemorrhaging, splenectomy is the treatment of choice.
Related Concept Videos
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Esophageal Varices-I: Introduction
Venous Thrombosis I: Introduction
Portal Hypertension
Hemorrhagic Stroke ll: Pathophysiology
Hepatic Portal System
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is responsible...