Korean J Med.  2003 Oct;65(4):480-485.

A case of gastric variceal bleeding associated with pancreatic endocrine tumor in the pancreas tail

• Im HM
• Kang MJ
• Namgung KY
• Ko BS
• Ahn HT
• Lee JR
• Han EM

Abstract

Isolated obstruction of the splenic vein leads to segmental portal hypertension, which is mainly originated from pancreatic disease, such as chronic pancreatitis, pancreatic pseudocyst, pancreatic cancer. The clinical manifestation are devoid of ascites and encephalopathy, but presented with gastric variceal bleeding. We experienced 27-year-old male patient who complained of hematochezia and melena. After work-up with CT and angiography, we performed operation with the impression of pancreatic tumor associated with splenic vein occlusion. It resulted nonfunctioning pancreatic endocrine tumor. Often called islet cell tumor, pancreatic endocrine tumor has various names according to secreted hormones, such as insulinoma, Zollinger-Ellison syndrome and glucagonoma. It was classified as nonfunctioning tumor if there were any evidence of hormone secretion by radioimmunoassay and immunohistochemistry. Surgical excision and adjuvant medical therapy is the mainstay of therapy. We performed tumor resection and splenectomy for control of gastric variceal bleeding due to splenic vein occlusion.

Keyword

Islet cell tumor; Gastric varix; Portal hypertension

MeSH Terms

Adenoma, Islet Cell
Adult
Angiography
Ascites
Esophageal and Gastric Varices*
Gastrointestinal Hemorrhage
Glucagonoma
Humans
Hypertension, Portal
Immunohistochemistry
Insulinoma
Male
Melena
Pancreas*
Pancreatic Diseases
Pancreatic Neoplasms
Pancreatic Pseudocyst
Pancreatitis, Chronic
Radioimmunoassay
Splenectomy
Splenic Vein
Zollinger-Ellison Syndrome