LEFT SIDED PORTAL HYPERTENSION AND ISOLATED GASTRIC VARICES FROM SPLENIC VEIN THROMBOSIS IN ACUTE PANCREATITIS IN CHILDREN

Abstract

Background: Left sided portal hypertension and isolated gastric varices (IGV) from splenic vein thrombosis (SVT) complicating pancreatitis and other pancreatic disorders have been described in 15-45% of adults; its incidence in children is unknown. Bleeding from gastric varices is more difficult to control and carries higher morbidity and mortality than esophageal varices. We report two children who developed IGV from SVT during the course of pancreatitis. Methods: Retrospective chart review of two children with IGV identified during upper endoscopic examination for gastrointestinal bleeding. Results: See Table.TableConclusions: 1. Isolated gastric varices from splenic vein thrombosis may occur in children with pancreatitis. 2. CT scan images should be evaluated for the presence of splenic vein thrombosis in children with pancreatitis. 3. Further studies are needed to define the risk of developing IGV from SVT in children for proper follow up. 4. Children presenting with abdominal symptoms and even mild elevation of pancreatic enzymes should have appropriate imaging studies to evaluate pancreatic pathology.