Acutely bleeding gastric varices. A rare manifestation of pancreatic cancer

Left-sided portal hypertension with gastrointestinal hemorrhage secondary to isolated obstruction of the splenic venous outflow is rare. Because of the anatomic relationship between splenic vein and pancreas, this rare presentation is usually caused by pancreatic inflammation or neoplasm. Here, an isolated splenic vein obstruction with left-sided portal hypertension, is presented. It led to acute, massive gastric varices bleeding which called attention to the rare manifestation of pancreatic cancer.