TWO CASES OF THE PANCREATIC DISEASES ASSOCIATED WITH VARICES OF THE STOMACH

Abstract

As a whole, it is known that esophagogastric varices is associated to patients with portal hypertention. But it is sometimes difficult to diagnose the gastric varices without esophageal varices endoscopically. We reported two cases of pancreatic disease accompanied with gastric varices in absence of esophageal varices. Case 1. A 38-year-old man with a complaint of hematoemesis. The tortuous and nodular varices with blood clots, in cardia was seen by endoscopic examination. Splenoportographic findings revealed stenotic pictures of splenic vein and remarkable gastric varices. Spleen was enlarged in size but liver was normal. Pancreas was atrophic and elastic hard in consistency. He was diagnosed to the stenosis due to pancreatitis, and splenectomy with devasculation of short gastric vein was performed in order to prevent gastric bleeding. Case 2. A 63-year-old female with complaints of hematoemesis and melena. Endoscopic findings showed tortuous varices with red-colour-sign. Celiac angiographic picture revealed a hypervascular tumor stain at the hilus of spleen and remarkable gastric varices, but any obstruction and stenosis of splenic vein were not seen. Total gastrectomy combined with splenectomy and resection of pancreas tail was performed. Histological diagnosis of this tumor was malignant islet cell tumor of the pancreas from which infiltrated directly into splenic parenchyma