title: Total gastrectomy after shunt failure as therapy for recurrent gastric variceal bleeding due to portal and mesenteric vein thrombosis.
abstract: A 37-yr-old man with portal hypertension due to portal vein thrombosis was referred because of recurrent episodes of variceal hemorrhage. He had previously undergone two portal-systemic shunt procedures. Both of the shunts, as well as the superior mesenteric vein, ultimately thrombosed. Endoscopic variceal sclerotherapy was able to control the bleeding from his esophageal varices, but he repeatedly bled from large gastric varices. The patient underwent a total gastrectomy and has had no further gastrointestinal hemorrhage during a follow-up of 36 months.
authors.affiliation: Center for Liver Diseases, University of Miami School of Medicine, Florida.
authors.forename: R T
authors.initials: RT
authors.lastname: Foust
authors.forename: K R
authors.initials: KR
authors.lastname: Reddy
authors.forename: A S
authors.initials: AS
authors.lastname: Livingstone
authors.forename: L J
authors.initials: LJ
authors.lastname: Jeffers
authors.forename: E R
authors.initials: ER
authors.lastname: Schiff
mesh_terms: D000328:Adult; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D005743:Gastrectomy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000150:complications*; D008642:Mesenteric Veins; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects; D013927:Thrombosis / Q000150:complications*