Massive bleeding from gastric submucosal arterial collaterals secondary to splenic artery thrombosis: A case report  

作　　者：Alberto Martino Marco Di Serafino Francesco Paolo Zito Franco Maglione Raffaele Bennato Luigi Orsini Alessandro Iacobelli Raffaella Niola Luigia Romano Giovanni Lombardi 

机构地区：[1]Department of Gastroenterology and Digestive Endoscopy,AORN“Antonio Cardarelli”,Napoli 80131,Italy [2]Department of General and Emergency Radiology,AORN“Antonio Cardarelli”,Napoli 80131,Italy [3]Department of Radiology,Sanatrix Clinic,Napoli 80127,Italy [4]Department of Pathology,AORN“Antonio Cardarelli”,Napoli 80131,Italy [5]Department of Interventional Radiology,AORN“Antonio Cardarelli”,Napoli 80131,Italy

出　　处：《World Journal of Gastroenterology》2022年第37期5506-5514,共9页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Gastric submucosal arterial collaterals(GSAC)secondary to splenic artery occlusion is an extraordinary rare and potentially life-threatening cause of acute upper gastrointestinal bleeding.Here,we report a case of massive bleeding from GSAC successfully treated by means of a multidisciplinary minimally invasive approach.CASE SUMMARY A 60-year-old non-cirrhotic gentleman with a history of arterial hypertension was admitted due to hematemesis.Emergent esophagogastroduodenoscopy revealed pulsating and tortuous varicose shaped submucosal vessels in the gastric fundus along with a small erosion overlying one of the vessels.In order to characterize the fundic lesion,pre-operative emergent computed tomography-angiography was performed showing splenic artery thrombosis(SAT)and tortuous arterial structures arising from the left gastric artery and the left gastroepiploic artery in the gastric fundus.GSAC was successfully treated by means of a minimally invasive step-up approach consisting in endoscopic clipping followed by transcatheter arterial embolization(TAE).CONCLUSION This was a previously unreported case of bleeding GSAC secondary to SAT successfully managed by means of a multidisciplinary minimally invasive approach consisting in endoscopic clipping for the luminal bleeding control followed by elective TAE for the definitive treatment.

关 键 词：Upper gastrointestinal bleeding Non variceal upper gastrointestinal bleeding Acute upper gastrointestinal bleeding Gastric submucosal arterial collaterals Splenic artery thrombosis Case report 

分 类 号：R573.2[医药卫生—消化系统]