Regional, portal hypertension in chronic pancreatitis

Because of a close anatomical relationship to the splenic vein chronic pancreatitis can cause obstruction to the splenic outflow. Regional portal hypertension develops and collateral flow sometimes gives rise to gastric and oesophageal varices which can cause life-threatening bleeding. Three cases with regional portal hypertension secondary to chronic pancreatitis are presented. Two of them were treated with surgical splenectomy and the third had an embolization of the splenic artery. Regional portal hypertension should be suspected in a patient with a history of chronic pancreatitis who is bleeding from gastric of oesophageal varices. The treatment of choice is surgical splenectomy. In high risk patients embolization of the splenic artery can be tried.