A rare case of serous cystadenoma of the pancreas presenting with left-sided portal hypertension.
We herein report the case of a 63-year-old woman with a serous cystadenoma of the pancreas presenting with left-sided portal hypertension secondary to isolated splenic vein occlusion. She was admitted to our hospital for sudden hematemesis. Emergency upper gastrointestinal endoscopy revealed hemorrhagic erosive gastritis and isolated varices in the gastric fundus. An abdominal angiographic study disclosed a large hypervascular tumor of the pancreatic tail which caused isolated splenic vein occlusion by tumor compression and formed large hepatopetal collaterals via the gastric varices. The patient underwent tumor resection with splenectomy and, as a result, the gastric varices disappeared and the postoperative course was uneventful. Left-sided portal hypertension secondary to splenic vein occlusion is an uncommon complication mostly associated with pancreatitis and pancreatic carcinoma. Although benign pancreatic neoplasms only rarely cause such a condition, the possibility of gastrointestinal bleeding due to this condition should be carefully taken into consideration when treating pancreatic disease.
Iwasaki
T
T
Department of Surgery, Gastroenterology, and Pathology, Seirei Mikatabara Hospital, Shizuoka, Japan.
Nagata
Y
Y
Watahiki
H
H
Yamamoto
H
H
Ogawa
H
H
D000792:Angiography; D018293:Cystadenoma, Serous / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000209:etiology*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed