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Updated: Jul 18, 2026
09:37
Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
Sinistral portal hypertension. A case report
Dinesh Singhal1, Rahul Kakodkar, Arvinder S Soin
1Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India.
JOP : Journal of the Pancreas
|November 11, 2006
Summary
Sinistral portal hypertension, caused by pancreatic issues leading to splenic vein thrombosis, presents with gastric variceal bleeding but preserved liver function. Splenectomy offers curative treatment for symptomatic bleeding patients.
Area of Science:
- Gastroenterology
- Hepatology
- Vascular Surgery
Background:
- Sinistral portal hypertension is characterized by gastric variceal hemorrhage secondary to splenic vein thrombosis, often stemming from pancreatic pathology.
- Key diagnostic features include preserved liver function and a patent extrahepatic portal vein, differentiating it from other portal hypertension forms.
Observation:
- Common causes include acute/chronic pancreatitis, pancreatic pseudocysts, and pancreatic carcinomas, with benign neoplasms being rare etiological factors.
- Splenic vein thrombosis occurs in 7-20% of pancreatitis/pseudocyst cases, but symptomatic bleeding affects only about 5% of patients.
Findings:
- Diagnosis relies on gastroscopy, liver function tests, Doppler ultrasound, and contrast-enhanced CT scans.
- Asymptomatic patients with pancreatitis may be managed expectantly; splenectomy is considered for symptomatic chronic pancreatitis with sinistral portal hypertension and varices.
Implications:
- Splenectomy, combined with pancreatic pathology treatment (e.g., distal pancreatectomy), provides curative and effective long-term results for gastric variceal hemorrhage.
- Understanding the link between pancreatic diseases and sinistral portal hypertension guides therapeutic strategies for this specific clinical syndrome.
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