What is the most appropriate management for a 38-year-old man with recurrent acute pancreatitis, bleeding fundal varices controlled by sclerotherapy, splenomegaly, a normal portal... What is the most appropriate management for a 38-year-old man with recurrent acute pancreatitis, bleeding fundal varices controlled by sclerotherapy, splenomegaly, a normal portal vein, and a thrombosed splenic vein?
Understand the Problem
The question is asking about the most appropriate management for a patient with recurrent acute pancreatitis, upper gastrointestinal bleeding from fundal varices, splenomegaly, a normal portal vein, and a thrombosed splenic vein, indicating that a splenectomy is suggested as the management option.
Answer
Splenectomy is the most appropriate management.
The most appropriate management for a 38-year-old man with recurrent acute pancreatitis and bleeding fundal varices, with a thrombosed splenic vein and normal portal vein, is splenectomy, as this addresses the underlying splenic vein thrombosis causing the varices.
Answer for screen readers
The most appropriate management for a 38-year-old man with recurrent acute pancreatitis and bleeding fundal varices, with a thrombosed splenic vein and normal portal vein, is splenectomy, as this addresses the underlying splenic vein thrombosis causing the varices.
More Information
Splenectomy effectively relieves the pressure by removing the spleen, thus addressing the thrombosed splenic vein, a common cause of left-sided portal hypertension also known as sinistral portal hypertension.
Tips
A common mistake is neglecting the underlying cause of the varices, which is splenic vein thrombosis in this case. It's crucial to treat the primary source of the problem rather than just controlling variceal bleeding.
Sources
- Left-Sided Portal Hypertension: A Sinister Entity | GE - Elsevier - elsevier.es
- Role of Splenic Artery Embolization in Gastric Variceal Hemorrhage - thieme-connect.com
AI-generated content may contain errors. Please verify critical information
