A 34-year-old woman, 30 weeks pregnant, with portal cavernomatosis since she was 7 years old.
During adolescence she presented three episodes of upper gastrointestinal bleeding secondary to esophageal varices (VE).
Anticoagulated due to acute venous thrombosis.
In the first trimester of pregnancy, beta-blockers and oral anticoagulants were removed and low weight heparin was started.
In gastroscopy performed to control esophageal varices 6 days before the event, grade I and II VE were observed without red signs.
She came to the emergency room for melena and hypotension.
Blood tests showed hemoglobin 7.1 g/dl. Urgent gastroscopy showed grade II VE with red spots and active bleeding, so ligation with elastic bands was performed.
It was decided to perform an urgent cesarean section for fetal extraction due to hypovolemic shock of the patient and then started treatment with somatostatin and was reviewed endoscopically, aiming at the cessation of bleeding.
Both newborns required care and were discharged within a few days of admission.
