2004 Volume 46 Issue 7 Pages 1333-1339
We reported the endoscopic characteristics of gastric varices caused by pancreatic diseases in G cases (chronic pancreatitis ;1, pancreatic carcinoma ; 4, metastatic pancreatic carcinoma ;1). In all cases, it was considered that localized portal hypertension was caused by the obstruction of the splenic vein due to the infiltration of pancreatic inflammation or carcinoma. The endoscopic features of these gastric varices were identified as widespread tortuous gastric varices locating from the cardia to the lower gastric body. These findings were seen in all cases. It was considered that these gastric varices were formed via two routes ; the collaterals from the short gastric vein to the portal vein via coronary veins and those from the short gastric vein to the portal vein via the gastro-epiploic vein. Thus, the formation of these gastric varices was considered specific endoscopic findings in the localized splenic venous hypertension. In addition, variceal bleeding was seen in 2 patients whose portal veins were not functioned as buffer vessels of hypertension in the splenic vein (liver cirrhosis in 1, post distal gastrectomy in 1). It is important to understand the hemodynamics of varices in cases with localized portal hypertension.
