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Introduction: Sinistral, or left-sided, portal hypertension SPH is a rare entity, with multiple potential causes. Gastrointestinal variceal bleeding and hypersplenism are its' major clinical manifestations. The main aim of the present study is to summarize the clinical features of patients with SPH.
Patients and methods: This was a retrospective analysis of consecutive patients with present or previous diagnosis of SHP, observed in a Gastroenterology Department, in a period of 2 years. Patients with clinical, radiological or laboratory alterations suggestive of cirrhosis were excluded.
Causes of SPH, clinical manifestations and outcomes were registered. Potential factors associated with gastrointestinal bleeding were analyzed.
Results: In the study period a total of 22 patients male - 17; mean age - Five Five patients There were no cases of variceal rebleeding and two patients died. Patients without liver enzymes elevation had a higher probability of gastrointestinal bleeding Conclusions: Acute and chronic pancreatitis are the major causes of SHP. Gastrointestinal bleeding is the most important clinical manifestation and patients without liver enzyme elevation seem more prone to bleed.
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Figure 1 13 Upper gastrointestinal endoscopy, showing fundal varices after treatment with cyanoacrylate. Upper gastrointestinal endoscopy, showing fundal varices after treatment with cyanoacrylate. Figure 2 5 CT image demonstrating splenomegaly and…. Figure 2 13 CT image demonstrating splenomegaly and splenic hilum varices.
Figure 3 5 Angiographic image demonstrating an arteriovenous…. Figure 3 13 Angiographic image demonstrating an arteriovenous malformation involving the splenic artery and veins. See this image and copyright information in PMC. Similar articles Sinistral portal hypertension: clinical features and surgical treatment of chronic splenic vein occlusion. Wang L, et al. Med Princ Pract. Epub Oct PMID: The different manifestation and outcome between pancreatitis and pancreatic malignancy with left-sided portal hypertension.
Hwang TL, et al. Int Surg. Sinistral left-sided portal hypertension. Evans GR, et al. Am Surg. Sinistral portal hypertension. A case report. Singhal D, et al. Terrinoni V, et al. G Chir. PMID: Review. Show more similar articles See all similar articles. Li H, et al. Med Sci Monit. Prevalence of splenic vein thrombosis and risk of gastrointestinal bleeding in chronic pancreatitis patients attending a tertiary hospital in western India.
Pandey V, et al. J Family Med Prim Care. Presumptive non-cirrhotic bleeding esophageal varices in a dog. Myers M, et al. J Vet Intern Med. Epub Sep References Little A. Gastrointestinal hemorrhage from left-sided portal hypertension. An unappreciated complication of pancreatitis.
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Madsen M. Segmental portal hypertension. Ann Surg. Sinistral portal hypertension: clinical features and surgical treatment of chronic splenic vein occlusion. Full-text links [x] Free PMC article.
Left-Sided Portal Hypertension: A Sinister Entity