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Related Concept Videos

Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Chronic Pancreatitis I: Introduction01:24

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Related Experiment Video

Updated: Feb 23, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
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Left-Sided Portal Hypertension: A Sinister Entity.

Alexandra Fernandes1, Nuno Almeida1,2, Ana Margarida Ferreira1

  • 1Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

GE Portuguese Journal of Gastroenterology
|September 5, 2017
PubMed
Summary

Sinistral portal hypertension (SPH) is often caused by pancreatitis. Gastrointestinal bleeding is a key symptom, with patients showing normal liver enzymes being more susceptible. Specific treatments are rarely needed.

Keywords:
Esophageal and Gastric VaricesHypertension PortalPancreatic NeoplasmsPancreatitis

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Vascular Surgery

Background:

  • Sinistral portal hypertension (SPH) is a rare condition with diverse etiologies.
  • Gastrointestinal variceal bleeding and hypersplenism are primary clinical concerns in SPH.
  • This study focuses on summarizing the clinical characteristics of SPH patients.

Purpose of the Study:

  • To delineate the clinical features of patients diagnosed with sinistral portal hypertension (SPH).
  • To identify the main causes and clinical manifestations of SPH.
  • To analyze factors associated with gastrointestinal bleeding in SPH patients.

Main Methods:

  • Retrospective analysis of 22 SPH patients over two years.
  • Exclusion of patients with clinical, radiological, or laboratory evidence of cirrhosis.
  • Documentation of SPH causes, clinical presentations, outcomes, and bleeding risk factors.

Main Results:

  • The primary causes of SPH were chronic pancreatitis (7), acute pancreatitis (7), and pancreatic cancer (4).
  • Gastrointestinal bleeding occurred in 8 patients, while 14 were asymptomatic or had abdominal pain.
  • Patients without elevated liver enzymes showed a significantly higher incidence of gastrointestinal bleeding (87.5% vs. 28.6%).

Conclusions:

  • Pancreatitis (acute and chronic) is the leading cause of SPH.
  • Gastrointestinal bleeding represents the most significant clinical manifestation of SPH.
  • Patients with normal liver enzyme levels appear to be at increased risk for gastrointestinal bleeding.