# Gastroesophageal Variceal Bleed Post Transcatheter Embolisation of the Left Gastric Artery

## TL;DR

A patient with chronic pancreatitis and portal hypertension experienced bleeding varices after artery embolisation, possibly due to increased blood flow.

## Contribution

This case report highlights a novel mechanism linking embolisation to variceal bleeding in non-cirrhotic portal hypertension.

## Key findings

- A patient with chronic pancreatitis and splenic vein thrombus developed a left gastric artery pseudoaneurysm.
- Post-embolisation, the patient experienced gastroesophageal variceal bleeding, likely due to increased splenic venous flow.
- The case suggests a new understanding of post-embolisation hemodynamic changes in non-cirrhotic portal hypertension.

## Abstract

Chronic pancreatitis has several complications that can lead to upper gastrointestinal bleeding (UGIB). Patients with chronic pancreatitis presenting with evidence of UGIB require careful assessment and investigation. We report a case of a patient presenting with anaemia and general fatigue with a background of chronic pancreatitis. He had known non-cirrhotic portal hypertension secondary to a chronic splenic vein thrombus. The patient was found to have a left gastric artery pseudoaneurysm. Following embolisation, the patient had episodes of haematemesis, and oesophagogastroduodenoscopy (OGD) identified bleeding gastroesophageal varices (GOV). We hypothesise a mechanism of increased blood flow into the splenic venous system post-embolisation, leading to variceal rupture.