Hi Dear !! Thanks for your query to HCM . Read and reviewed your query and health concerns. IN the given situation, You seems to suffer from-Splenic Vein Thrombosis(SVT) with resultant SPH(Sinistral Portal Hypertension)with gastric Varices,leading to stomach haemorrhage with malena. Endoscopy confirmed gastric varices,as the cause of malena. Remedy- Consult Surgeon-who would plan Spleenectomy. Better Solution for splenic Vein clot causing malena from bleeding gastric varices. But with interventional radiologist availability, optional treatment of -Splenic arterial emobolization to treat the gastric bleeding causing malena, is the upcoming standard treatment in such cases of splenic vein clot. common cause of this clot would be pancreatic pathology/ post-pancreatitis causing splenic vein thrombosis with clot. Enhanced Constrast CT abdomen scan with USG abdomen in combination with LFT and gastroscopy would help in fixing timely treatment in your case. Other causes need to be ruled out. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following HCM link-http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70229 Dear, if satisfied,Don t forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at HCM services. If you want to update more details and ask more update queries , You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Dr.Savaskar M.N. Senior Surgical Specialist M.S.Genl-CVTS