Pancreatic Pseudocyst-Induced Gastric Varices: A Rare Case of Extrahepatic Portal Hypertension?

摘要

Extrahepatic hypertension of the portal venous system (EPH) in the absence of liver cirrhosis is characterized as either occlusive or nonocclusive in origin. Isolated gastric varices can develop in patients with seg-mental or left-sided portal hypertension (LSPH). We report a case of isolated gastric varices secondary to a nonocclusive form of LSPH due to a large pancreatic pseudocyst. A 37-year-old man was admitted to our facility due to acute onset of nausea, vomiting, and inability to tolerate both solids and liquids for 24 hours. He had a significant past medical history of chronic pancreatitis and an enlarged pancreatic pseudocyst as a result of chronic alcoholism. He denied any history of hepatitis, cirrhosis, or gastrointestinal bleeding and confirmed sobriety of one month. Physical examination revealed a palpable large midabdominal mass without any abdominal pain, hepatosplenomegaly, jaundice, lymphadenopathy, or caput madusae. The remainder of the patient's systemic examination was unremarkable.