MASSIVE bleeding into the gastrointestinal tract may be caused by splenic vein obstruction due to involvement of the pancreas by neoplasms, either primary or secondary, or by cysts. Interference with the return flow of venous blood from the spleen may result in congestive splenomegaly, gastric varices, and at times esophageal varices. Fatal hemorrhage from ruptured varices may be prevented in such situations by splenectomy. Recently there have been three patients on the surgical division at this hospital in whom death due to exsanguination was averted by removal of the spleen and the obstructing tumor.
REPORT OF CASES
—M. R. (Montefiore Hospital admission number 53369). The case history of this 51-year-old white man has been reported in detail in a previous publication.1 Because of massive melena, he had been treated in another institution with repeated blood transfusions. At this hospital he was found to have gastric varices and