Small bowel varices from neuroendocrine tumor of the pancreas.

Abstract

Small bowel varices (SBVs) are a rare but important cause of gastrointestinal (GI) bleeding. We present a case of SBVs caused by superior mesenteric vein thrombosis from a large neuroendocrine tumor of the pancreas. This patient presented with GI bleeding. A computed tomography scan showed an incidental hypervascular mass that was unresectable. After exhaustive work-up, the GI bleeding was in fact due to the mass by direct compression on the superior mesenteric vein. The SBVs were evident on the venous phase of a computed tomography angiogram. The patient was treated medically with octreotide, beta-blockade, and external beam radiation therapy applying the physiology of esophagogastric varices to the small bowel. Persistent GI bleeding in the presence of a large central mass should always alert one to consider varices from collateral flow as a possible cause.

• Authors: Shimul A Shah, Carlos M Mery, Michael J Zinner
• Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) 2005 Sep-Oct Vol. 9 Issue 7 Pg. 912-4 ISSN: 1091-255X [Print] United States
• PMID: 16137583 (Publication Type: Case Reports, Journal Article)

Topics

• Aged, 80 and over
• Constriction, Pathologic (etiology)
• Female
• Gastrointestinal Hemorrhage (etiology)
• Humans
• Intestine, Small (blood supply)
• Mesenteric Vascular Occlusion (etiology)
• Mesenteric Veins (pathology)
• Neuroendocrine Tumors (complications)
• Pancreatic Neoplasms (complications)
• Varicose Veins (etiology)
• Venous Thrombosis (etiology)