Bleeding gastric varices and antiphospholipid syndrome.
BACKGROUND
A 35-year-old woman with a past history of antiphospholipid syndrome and near-fatal vascular thrombosis was transferred to Glasgow Royal Infirmary, UK, for investigation of 'obscure' gastrointestinal bleeding in the context of long-term oral anticoagulation therapy. Initial endoscopic examination revealed isolated gastric varices with stigmata of recent hemorrhage. She had no prior history of liver disease or portal hypertension. Investigations to ascertain the cause of her varices were performed.


METHODS
CT venography, endoscopic ultrasound and transjugular liver biopsy.


METHODS
Nodular regenerative hyperplasia of the liver leading to gastric varices.


RESULTS
Endoscopic histacryl tissue-glue injection followed by transjugular intrahepatic portosystemic shunt and long-term oral anticoagulation therapy.
Gaya
Daniel R
DR
Department of Gastroenterology, Glasgow Royal Infirmary, UK. danielgaya@aol.com
Oien
Karin A
KA
Stanley
Adrian J
AJ
Morris
Allan J
AJ
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis; D001706:Biopsy; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D010690:Phlebography; D014057:Tomography, X-Ray Computed