Tehran University Medical Journal

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Background: Chronic pancreatitis and perivasculitis is the most common etiology of splenic vein thrombosis (SVT). Reported in up to 45% of patients with chronic pancreatitis, SVT may also be seen in patients with acute pancreatitis and pancreatic adenocarcinoma. It causes a localized portal hypertension called sinistral portal hypertension. Unlike those with generalized portal hypertension, patients with sinistral portal hypertension are asymptomatic and have normal liver function. Upper gastrointestinal bleeding from gastric varices is a life threatening complication of SVT. In patients with gastrointestinal bleeding secondary to esophageal or gastric varices, late-phase celiac angiography is used to determine the presence SVT. Splenectomy is effective in treating the collateral outflow for patients with massive gastrointestinal bleeding.
Case report: a 23-year-old patient with SVT due to chronic pancreatitis with gastrointestinal bleeding. The patient came to the hospital with upper gastrointestinal bleeding of unknown etiology. Diagnostic workups revealed chronic pancreatitis and SVT with bleeding gastric fundal varices, after which the patient underwent splenectomy. A review of current literature on SVT, known etiologies, diagnosis and treatment is discussed

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Background: Chronic pancreatitis is a progressive fibrosis of the pancreas that leads to loss of endocrine and exocrine function of pancreas. The most common symptom is intractable pain. Which adversely effects quality of life, remains the most common indication for surgery in patients with chronic pancreatitis.

Case report: Three patients underwent operations for chronic pancreatitis at the Ghaem hospital, Mashhad University of Medical Sciences Mashhad, Iran. Indication for operation in all cases were intractable abdominal pain. In all of the three patients complete relief of symptoms was obtained. There was no morbidity and mortality. In one patient exocrine function of pancreas and malabsorpation resolved after surgery.

Conclusions: Although chronic pancreatitis is uncommon, but in persistent abdominal pain surgery should be considered. Surgery for patients with chronic pancreatitis can be performed safely with minimal morbidity and effective in control of pain and malabsorption.