A 71-year-old woman was admitted to our hospital for 
treatment of cancer in the body and tail of the pancreas.  After 
admission, she had tarry stool and esophagogastroduodenoscopy 
(EGD) was performed.  EGD revealed enlarged tortuous, red 
color sign negative gastric varices between the cardiac orifice, 
fundus and the curvature ventriculi major of the gastric body.  
Computed tomography showed gastric varices due to splenic 
vein occlusion with advanced pancreatic cancer (left-sided portal 
hypertension).  
endoscopic 
However, endoscopic observation was not 
sufficient to identify the bleeding site of the gastric varices.  
Consecutively, endoscopic color Doppler ultrasonography 
(ECDUS) was performed to evaluate the gastric varices in detail.  
ECDUS showed the velocity of gastric varices in the cardiac 
orifice and fundus to be 11.7 cm/sec, the thickness of the gastric 
wall to the submucosal gastric varices being 1.0 mm, and the 
gastric varices in the cardiac orifice and fundus were diagnosed 
as the likely bleeding site.  
Subsequently, we performed 
obliterative 
therapy with 70% n-butyl-2
cyanoacrylate diluted with 5% Lipiodol at the possible bleeding 
site of these varices.  The patient experienced no further episodes 
of bleeding during the three months following treatment.   
Keywords: Gastric Varices; Splenic Vein Occlusion; 
Endoscopic Ultrasonography; Color Doppler; Left-Sided Portal 
Hypertension