Gastric Variceal Bleed in Pregnancy.
Junaid Ahmed, Kranthi Dandi, Amol S Dahale et al.
✦ AI-curated · Sources linked
Case in brief
A 25-year-old primigravida at 18 weeks’ gestation presented with hematemesis and melena, with pallor, tachycardia, splenomegaly, anemia, and thrombocytopenia. Doppler ultrasound showed a portal cavernoma. Endoscopy identified large esophageal and fundal GOV2 gastric varices with signs of recent bleeding, as well as portal hypertensive gastropathy. Cyanoacrylate injection controlled active gastric variceal bleeding; esophageal varices were ligated 48 hours later, with complete obliteration. She remained stable, had no further pregnancy complications, and delivered a healthy baby by elective cesarean section at 39 weeks.
What made this case unusual
The case involved active gastric variceal bleeding from GOV2 varices during the second trimester, alongside large esophageal varices and a portal cavernoma; endoscopic treatment was staged during pregnancy.
Diagnostic / clinical pearl
In a pregnant patient with hematemesis and melena, portal hypertension-related variceal bleeding should be considered; Doppler ultrasound and endoscopy can identify the underlying portal cavernoma and bleeding varices.
Why it matters
The reported favorable maternal and fetal outcomes followed endoscopic hemostasis and close multidisciplinary follow-up, illustrating the feasibility of coordinated management in this case.