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Pancreatic mass leading to left-sided portal hypertension, causing bleeding from isolated gastric varices

Helga Thrainsdottir1, Vigdis Petursdottir2, Sigurdur Blöndal3

  • 1Section of Gastroenterology, Department of Internal Medicine, The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland ; Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland.

Case Reports in Gastrointestinal Medicine
|December 20, 2014
PubMed

Insights

Mucinous cystic neoplasms (MCNs) can cause rare complications like left-sided portal hypertension, leading to gastric varices. This case highlights unusual symptoms of iron-deficiency anemia instead of typical bleeding in MCN patients.

Area of Science:

  • Gastroenterology
  • Oncology
  • Surgical Pathology

Background:

  • Mucinous cystic neoplasms (MCNs) are rare pancreatic exocrine tumors.
  • Vague symptoms often delay MCN diagnosis.
  • Complications like portal hypertension are infrequently reported.

Purpose of the Study:

  • To report a rare case of MCN causing left-sided portal hypertension.
  • To highlight unusual clinical presentations of MCN.
  • To discuss the diagnostic challenges and management of MCN complications.

Main Methods:

  • Case report of a 34-year-old woman.
  • Clinical presentation with dizziness and lethargy.
  • Imaging revealed a 12 cm pancreatic MCN.

Main Results:

  • The MCN caused left-sided portal hypertension.
  • This led to isolated gastric varices and bleeding.
  • The patient presented with iron-deficiency anemia, not hematemesis.

Conclusions:

  • MCNs can present with atypical symptoms, including iron-deficiency anemia.
  • Left-sided portal hypertension is a rare but serious complication of MCN.
  • Early diagnosis and management are crucial for favorable outcomes.

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