Early Recognition of Isolated Splenic Vein Thrombosis: Diagnostic Value of Endosonography

A 71‐year‐old man was followed‐up for chronic pancreatitis and gastric mucosal cancer after endoscopic resection. Repeated endoscopic ultrasonography incidentally depicted isolated gastric varices and paramural collateral vessels, which had gone unrecognized on conventional endoscopy and abdominal ultrasonography. The features of subsequent angiography were consistent with isolated splenic vein thrombosis. Isolated splenic vein thrombosis, which often follows pancreatitis, is characterized by gastric varices and splenomegaly without portal hypertension. This condition has a poor medical prognosis due to possible variceal hemorrhage, if the condition is left undiagnosed. For patients with chronic pancreatitis, we should not only examine the pancreas but also check for gastric varices using endoscopic ultrasonography, which is a non‐invasive yet sensitive procedure for uncovering this abnormality.