Splenic vein obstruction (usually due to
thrombosis) induces left-sided portal hypertension and isolated fundal varices in patients with
unaffected liver parenchyma and permeable portal vein. Pancreatic etiology is among the most
frequent for splenic vein thrombosis. Hemorrhage from isolated fundal varices is a lifethreatening
situation and an unusual endoscopic finding. Isolated splenic vein thrombosis with
gastric varices is rare and represents one of the few curable syndromes inducing portal
hypertension. The treatment for this situation is controversial, various options being described in
the literature: endoscopic injection hemostasis, interventional radiology techniques and surgery.
We herein describe the clinical case of a 50-year old patient with bleeding fundal varices, which
proved to be attributable to a blunt abdominal trauma thirty six years previously, successfully
managed by stapling fundectomy with splenectomy.