Sinistral portal hypertension
Splenic vein
stenting for recurrent chylous ascites in sinistral portal hypertension: a case report. Digital subtraction venography of the splenic vein prior to venoplasty reveals multiple areas of stenosis and robust venous collaterals from portal hypertension
Splenic vein
stenting for recurrent chylous ascites in sinistral portal hypertension: a case report. Digital subtraction venography of the splenic vein after deployment of splenic stents shows increased splenic venous patency with resolution of splenoportal collaterals
Sinistral portal hypertension (also known as left-sided portal hypertension or segmental portal hypertension) is an uncommon form of portal hypertension.
Clinical presentation
Sinistral portal hypertension is most commonly found incidentally in asymptomatic patients. In symptomatic patients, the most common presentation (although rare) is gastrointestinal bleeding from esophageal or gastric varices .
Splenomegaly is common (~70%). Cirrhosis and ascites are not common presenting features .
Pathology
Sinistral portal hypertension results from occlusion of the splenic vein, usually from pancreatic pathology (e.g. pseudocyst, carcinoma).
