위정맥류 출혈과 비장경색을 합병한 만성췌장염

Splenic infarction is an uncommon form of splenic pathology. It occurs as a consequence of systemic thromboembolization in association with several cardiovascular disorders. Other etiologic factors include splenic vascular disease, anatomic abnormalities, collagen vascular disease, nonhematologic malignancy, and pancreatic disease in the extremely rare form. Pancreatic disease may result in splenic infarction because of constriction of the splenic vessels by the fibrotic pancreas, tortuous aneurysm, or thrombosis of splenic vein. A pseudocyst in the tail of the pancreas may dissect into the hilum, causing vascular compromise and infarction. Recently we experienced a 47-year old man cpmplaining of left upper quadrant pain, which was diagnosed as gastric variceal bleeding and splenic infarction associated with chronic fibrosing pancreatitis confirmed by ultrasonogram of abdomen, abdominal CT, angiography, and operation. Distal pancreatectomy and splenectomy were performed, and subsidence of his symptoms was observed. We report this case with a review of the relevant literature. (Korean J Gastroenterol 1995;27:611 - 616)