Published online Oct 7, 2022. doi: 10.3748/wjg.v28.i37.5506
Peer-review started: June 18, 2022
First decision: July 11, 2022
Revised: July 17, 2022
Accepted: September 8, 2022
Article in press: September 8, 2022
Published online: October 7, 2022
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.
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 inva
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.
Core Tip: Gastric submucosal arterial collaterals (GSAC) secondary to splenic artery occlusion is an extremely rare cause of severe non variceal upper gastrointestinal bleeding. Herein, we describe a previously unreported case of massive bleeding from GSAC secondary to splenic artery thrombosis effectively treated by endoscopic mechanical hemostasis followed by endovascular embolization.