Isolated gastric varices associated with antiphospholipid syndrome and protein S deficiency: a case report and review of the literature.
Xueyan LiJiandi WuFeifei FangYing LiuWewei JiangGangping LiJun SongPublished in: The Journal of international medical research (2024)
The mortality rate of gastric varices bleeding can reach 20% within 6 weeks. Isolated gastric varices (IGVs) refer to gastric varices without esophageal varices and typically arise as a common complication of left portal hypertension. Although IGVs commonly form in the setting of splenic vein occlusion, the combination of antiphospholipid syndrome and protein S deficiency leading to splenic vein occlusion is rare. We herein present a case of a 28-year-old woman with intermittent epigastric pain and melena. She was diagnosed with antiphospholipid syndrome based on the triad of pregnancy morbidity, unexplained venous occlusion, and positive lupus anticoagulant. Laparoscopic splenectomy and pericardial devascularization were performed for the treatment of IGVs. During the 6-month postoperative follow-up, repeated endoscopy and contrast-enhanced computed tomography revealed disappearance of the IGVs. This is the first description of splenic vein occlusion associated with both antiphospholipid syndrome and protein S deficiency. We also provide a review of the etiology, clinical manifestations, diagnosis, and treatment methods of IGVs.
Keyphrases
- contrast enhanced
- computed tomography
- magnetic resonance imaging
- magnetic resonance
- protein protein
- replacement therapy
- atrial fibrillation
- diffusion weighted
- amino acid
- blood pressure
- systemic lupus erythematosus
- binding protein
- type diabetes
- chronic pain
- patients undergoing
- cardiovascular disease
- spinal cord injury
- high intensity
- pain management
- pregnant women
- rheumatoid arthritis
- pet ct
- combination therapy
- small bowel