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SINISTRAL PORTAL HYPERTENSION

SELWYN J.KUMAR. .

Abstract


Abstract : Sinistral portal hypertension is a rare condition,
which produce isolated gastric varices and upper
gastrointestinal bleeding. It is due to splenic vein thrombosis
which is often secondary to pancreatic disease
(inflammations, tumors). Initial treatment is conservative. After
successful conservative treatment early surgery should be
considered. UGI Scopy, liver function tests, USG abdomen
(with Doppler) and CECT or CT Angiogram are the
investigations necessary for the diagnosis. Splenectomy
absolutely eliminates the risk from gatric rebleeding.
Prognosis depends on the etiology of pancreatic disease. We
present a case of 37 year old man who was successfully
treated with splenectomy for gastric bleeding caused by
Sinistral portal hypertension followed by a literature review of
the reported causes, pathophysiology and management of
Sinistral portal hypertension.


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