Effective Control of Pancreatitis-Related Gastric Varices Through Splenic Artery Embolization: A Case Report

The development of isolated gastric varices (IGVs) is a rare manifestation in the setting of chronic pancreatitis (CP). However, due to the proximity of the pancreas to the splenic vein, splenic vein thrombosis (SVT) secondary to compression from CP can lead to the development of IGVs. We report a case of a 57-year-old patient with a history of CP status post Whipple procedure with upper GI bleeding from IGV formation. Initial endoscopic evaluation revealed scattered and prominent bleeding varies in the stomach with no evidence of esophageal variceal development. Subsequent CT angiography revealed SVT as the underlying cause of the variceal formation. The patient initially received medical management with IV sandostatin for bleeding control, and a splenectomy was planned as the definitive management. However, because the patient had undergone a Whipple procedure and developed fragile scattered varices, splenic artery embolization was chosen over splenectomy. Splenic artery embolization led to a successful reduction in gastric variceal size and no recurrence of bleeding. This case report presents a case of pancreatitis-induced splenic vein thrombosis (PISVT) and highlights splenic artery embolization as a viable management strategy in such cases.