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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

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Asymptomatic Extrahepatic Portal Venous Obstruction: A Case Report.

Priscilla Johnson¹, Johnson Wms², Senthil N³

¹Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Chennai, IND.

|August 8, 2024

Summary

This case report details extrahepatic portal venous obstruction (EHPVO) and esophageal varices, highlighting the importance of timely intervention to prevent severe bleeding. Early diagnosis and management are crucial for patients presenting with related symptoms.

Keywords:

acute calculus cholecystitis extrahepatic portal venous obstruction oesophageal varices portal hypertension “pancytopenia”

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Area of Science:

Gastroenterology
Vascular Medicine
Hepatology

Background:

Extrahepatic portal venous obstruction (EHPVO) is a rare condition.
Portal venous thrombosis can lead to serious complications like esophageal varices and bleeding.
Hypersplenism is a common sequela of portal hypertension.

Observation:

A 56-year-old female presented with pancytopenia and fatigue.
Past medical history included acute calculus cholecystitis treated with partial cholecystectomy.
Laboratory tests indicated hypersplenism; MRI confirmed EHPVO; endoscopy revealed grade IV esophageal varices.

Findings:

The patient was diagnosed with EHPVO and significant esophageal varices.
Endoscopic variceal banding was performed for bleeding prophylaxis.
Beta-blockers were initiated for secondary prevention of gastrointestinal bleeding.

Implications:

This case underscores the need for increased awareness and diagnostic vigilance for EHPVO.
Standard management involves endoscopic therapy and pharmacological prophylaxis.
Further research is needed to establish clear management guidelines for EHPVO.