Diagnosis and treatment of upper gastrointestinal hemorrhage caused by pancreatic segmental portal hypertension

Objective To investigate the diagnosis and treatment of upper gastrointestinal hemorrhage caused by pancreatic segmental portal hypertension. Methods The clinical diagnosis and follow-up data of 13 patients with upper gastrointestinal hemorrhage caused by pancreatic segmental portal hypertension from Jan 2010 to Dec 2017 were retrospectively analyzed. Results Of the 13 patients, 5 had pancreatic pseudocysts and 8 had chronic pancreatitis. All of them had a history of hematemesis or (and) tarry feces, and 2 of them had a history of hemorrhagic shock. 13 patients had isolated gastric varices, and 5 of them had varicose veins in the lower esophagus. 13 patients had splenomegaly and hypersplenism, and all patients underwent splenectomy. All patients were followed up, and the varicose veins were significantly improved or disappeared. During 1 year to 8 years of follow-up, there was no rebleeding. Conclusion Splenectomy cures upper gastrointestinal hemorrhage caused by rupture of the varicose veins in patients of pancreatic segmental portal hypertension. Preoperative interventional spleen artery embolization can reduce the difficulty of spleen resection. Key words: Hypertension, portal; Pancreatic diseases; Gastrointestinal hemorrhage