Isolated gastric varices associated with antiphospholipid syndrome and protein S deficiency: a case report and review of the literature

Autor: Xueyan Li, Jiandi Wu, Feifei Fang, Ying Liu, Wewei Jiang, Gangping Li, Jun Song
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of International Medical Research, Vol 52 (2024)
Druh dokumentu: article
ISSN: 1473-2300
03000605
DOI: 10.1177/03000605241240579
Popis: 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.
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