Bleeding isolated gastric varices: a retrospective analysis.

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dc.contributor.authorNagral, Sen_US
dc.contributor.authorShah, Sen_US
dc.contributor.authorGandhi, Men_US
dc.contributor.authorMathur, S Ken_US
dc.date.accessioned1999-04-13en_US
dc.date.accessioned2009-05-29T02:31:34Z
dc.date.available1999-04-13en_US
dc.date.available2009-05-29T02:31:34Z
dc.date.issued1999-04-13en_US
dc.description.abstractOBJECTIVE: Isolated gastric varices (IGV) are rare and are believed to be associated with left-sided portal hypertension. We studied patients presenting with bleeding from IGV and compared them with those bleeding from both esophageal and gastric varices. METHODS: A retrospective analysis of 14 patients with bleeding from IGV was carried out. Portovenography findings (pattern of collateralization and natural shunts) in these patients were compared with a matched group of 69 patients with both esophageal and gastric varices. RESULTS: Of 14 patients with IGV, 2 had isolated splenic vein thrombosis and 12 had generalized portal hypertension. Portovenograms in 11 of the latter 12 revealed predominantly 'left-sided' collateralization in 8 patients as compared to 17 of 69 (25%) patients with esophageal and gastric varices (p = 0.004); natural shunts were seen in 6 of 11 cases and 15 of 69 (22%) patients in the two groups, respectively (p = 0.05). Abdominal devascularization operation gave good short- and long-term control of bleeding. CONCLUSIONS: Contrary to belief most patients with isolated gastric varices may have generalized portal hypertension rather than splenic vein obstruction as the cause and hence should be treated by a more extensive procedure than just splenectomy. The IGV could be a result of predominant collateralization to the retroperitoneal area (left-sided collateralization and natural shunts) rather than the usual pattern to the azygos system which results in esophageal varices.en_US
dc.description.affiliationDepartment of Surgery, King Edward VII Memorial Hospital, Mumbai. nagral@bom3.vsnl.net.inen_US
dc.identifier.citationNagral S, Shah S, Gandhi M, Mathur SK. Bleeding isolated gastric varices: a retrospective analysis. Indian Journal of Gastroenterology. 1999 Apr-Jun; 18(2): 69-72en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/64248
dc.language.isoengen_US
dc.source.urihttps://www.indianjgastro.comen_US
dc.subject.meshEsophageal and Gastric Varices --epidemiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGastrointestinal Hemorrhage --epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertension, Portal --epidemiologyen_US
dc.subject.meshIndia --epidemiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRetrospective Studiesen_US
dc.titleBleeding isolated gastric varices: a retrospective analysis.en_US
dc.typeJournal Articleen_US
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