[Bleeding from gastric varices as the initial manifestation of primary pancreatic lymphoma].
In patients with pancreatic cancer, the most frequent symptoms are abdominal pain, weight loss and jaundice. Upper gastrointestinal bleeding produced by gastric varices is a rare entity in these patients and requires the presence of splenic vein thrombosis (SVT) to be excluded. We describe the case of a young man who presented to the emergency department with hematemesis. Diagnostic tests revealed primary pancreatic lymphoma (PPL), which provoked splenic vein thrombosis, collateral circulation and the formation of isolated bleeding gastric varices. To date, we have found no reports in the literature of PPL with this form of presentation. Finally, we review the literature, with emphasis on the importance of excluding splenic vein thrombosis in patients with isolated gastric varices, and discuss certain features of the diagnosis and treatment of PPL.
Vida Pérez
Luis
L
Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, España. lvp80@hotmail.com
González Galilea
Angel
A
Fraga Rivas
Enrique
E
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D017728:Lymphoma, Large-Cell, Anaplastic / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008551:Melena / Q000209:etiology; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D011859:Radiography; D013162:Splenic Vein; D020246:Venous Thrombosis / Q000209:etiology*