Massive Esophagogastric Variceal Bleeding from Chronic Portal Vein Thrombosis in a Non-Cirrhotic Young Man: A Resource-Limited Endoscopic Management Dilemma.
Osman Ahmed Tahajud, Omar Hassan Ahmed
✦ AI-curated · Sources linked
Case in brief
A 31-year-old man presented with massive hematemesis, melena, and hemorrhagic shock, with a hemoglobin level of 3.5 g/dL. He was stabilized through resuscitation and medical therapy. Endoscopy revealed large esophageal varices and a bleeding GOV2 varix. Due to local limitations, immediate band ligation was deferred, and he was referred for definitive therapy. He was discharged on day 5 without rebleeding.
What made this case unusual
The case illustrates massive variceal bleeding from chronic portal vein thrombosis in a non-cirrhotic patient, which is less commonly reported.
Diagnostic / clinical pearl
Clinicians should recognize that chronic portal vein thrombosis can lead to significant noncirrhotic portal hypertension and variceal bleeding, necessitating careful management in resource-limited settings.
Why it matters
This case underscores the importance of timely referral for definitive treatment in acute variceal hemorrhage, especially when local resources are inadequate.