October 1971

Palmar Varices and Gastrointestinal Bleeding

Author Affiliations


From Philadelphia General Hospital, Jefferson Medical College of Philadelphia, and the Cardeza Foundation for Hematologic Research, Philadelphia.

Arch Intern Med. 1971;128(4):598-599. doi:10.1001/archinte.1971.00310220106016

In patients with gastrointestinal bleeding, a close inspection of the skin and mucous membranes may produce rewarding diagnostic possibilities.1 Vascular lesions such as telangiectases, hemangiomas, and phlebectasia may have gastrointestinal counterparts.2-4

The present communication describes a patient with repeated gastrointestinal bleeding from isolated gastric varices, without evidence of portal or splenic vein hypertension, who also demonstrated striking variceal changes of the veins of the hands.

Patient Summary  A 69-year-old white man was hospitalized the second time for gastrointestinal bleeding. Fourteen months earlier, upper-gastrointestinal tract bleeding prompted exploratory laparotomy. Results of an x-ray series of the upper gastrointestinal tract performed preoperatively were normal. A large bleeding varix of the antrum was found (Fig 1), and partial gastrectomy was performed. The splenic and portal veins appeared normal and patent. Esophageal varices could not be identified.On the second admission, repeated exploration revealed a bleeding varix on the greater curvature of

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