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Case Reports in Vascular Medicine
Volume 2013, Article ID 538259, 4 pages
http://dx.doi.org/10.1155/2013/538259
Case Report

Pulmonary-Esophageal Variceal Bleeding: A Unique Presentation of Partial Cor Triatriatum Sinistrum

1Department of Critical Care Medicine, Florida Hospital Celebration Health, Celebration, FL 34747, USA
2Department of Radiology, Florida Hospital Orlando, Orlando, FL 32803, USA

Received 18 September 2013; Accepted 29 October 2013

Academic Editors: H. Matsumoto and H. Nakajima

Copyright © 2013 Fortune O. Alabi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cor triatriatum sinistrum is a rare congenital disorder defined as a division of the left atrium by a diaphragmatic membrane resulting in two left atrial chambers. The membranous division of the atrium can be partial or complete and can affect either atrium, with involvement of the right atrium referred to as cor triatriatum dexter. The presence of fenestrations within the membrane allows for communication and forward passage of blood into the true atrium. Absence of fenestrations leads to early symptomatic engorgement of the lungs. We report the case of a young adult male presenting with recurrent hematemesis due to variceal bleeding. On CT imaging the patient was found to have cor triatriatum sinistrum, with a vertical membrane resulting in total obstruction of the pulmonary venous drainage on the right, with normal pulmonary venous drainage on the left. There was extensive pulmonary-systemic arterial collateralization to the right lung suggesting retrograde filling of the right pulmonary artery with effective flow reversal in the right lung.