Nine patients with splanchnic venous thrombosis are presented and the value of noninvasive imaging in their initial diagnosis and subsequent follow-up is emphasized. Angiography, traditionally the definitive investigation in such cases, can be reserved for preoperative assessment in those patients considered candidates for surgery. The age of venous thrombi can be estimated by computed tomography (CT) and magnetic resonance imaging (MRI) which aids selection of therapy, and in those anticoagulated, prediction of prognosis.
A case of a blue rubber bleb nevus syndrome in a 19-year-old female patient with multiple cutaneous and gastrointestinal hemangiomata is described. Recurrent GI bleeding resulted in severe chronic anemia, which was successfully treated by endoscopic laser photocoagulation and surgical resection. Both forms of therapy had to be repeated 4 years later, the patient having been well in the meantime. This combined endoscopic and surgical approach might also improve the survival of patients with severe GI hemorrhage due to blue rubber bleb nevus syndrome.
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