What is sinistral portal hypertension?
What is sinistral portal hypertension?
Sinistral portal hypertension is a rare, less than 1%, but life threatening cause of upper gastric bleeding [1, 2,3]. It is commonly caused by an occlusive thrombus in the splenic vein which could lead to formation of lieno(spleno)-gastric varices in order to decompress increased pressure in the splenic vein [1].
What is left sided hypertension?
Left-sided portal hypertension (LSPH), also known as segmental, regional, localized, compartmental, lineal, splenoportal, or sinistral hypertension is a rare, but life threatening cause of upper gastrointestinal bleeding. It usually occurs as a result of isolated obstruction of the splenic vein.
Why does splenic vein thrombosis cause portal hypertension?
Splenic vein occlusion results in back pressure which is transmitted through its anastomoses with the short gastric and gastroepiploic veins and subsequently via the coronary vein into the portal system. This results in reversal of flow in these veins and the formation of gastric varices.
Does pancreatitis cause portal hypertension?
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.
How does pancreatitis cause portal hypertension?
What is splenic vein?
The splenic vein (formerly the lienal vein) is a blood vessel that drains blood from the spleen, the stomach fundus and part of the pancreas. It is part of the hepatic portal system.
What is the most common cause of portal hypertension?
Cirrhosis is the most common cause of portal hypertension, and chronic viral hepatitis C is the most common cause of cirrhosis in the United States. Alcohol-induced liver disease and cholestatic liver diseases are other common causes of cirrhosis.
