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. 2020 Jun 26;6(1):148.
doi: 10.1186/s40792-020-00912-y.

Left-sided portal hypertension caused by idiopathic splenic vein stenosis improved by splenectomy: a case report

Hikaru Hayashi  1 , Akira Shimizu  2 , Hiroaki Motoyama  2 , Koji Kubota  2 , Tsuyoshi Notake  2 , Tomohiko Ikehara  2 , Koya Yasukawa  2 , Akira Kobayashi  2 , Yuji Soejima  2
Affiliations

Left-sided portal hypertension caused by idiopathic splenic vein stenosis improved by splenectomy: a case report

Hikaru Hayashi et al. Surg Case Rep. .

Abstract

Background: Splenic vein stenosis and occlusion, which are known causes of left-sided portal hypertension, often occur secondary to trauma, pancreatitis, or invasion or compression by pancreatic tumors. However, few reports have described idiopathic splenic vein stenosis.

Case presentation: A 70-year-old man was referred to our hospital for examination of isolated gastric varices. He had no history of liver disease, pancreatitis, or abdominal trauma. Computed tomography revealed stenosis of almost the entire length of the splenic vein, and development of gastric fundal and short gastric varices. No inflammatory changes or neoplastic lesions of the pancreas were observed in any imaging study. The patient was diagnosed with left-sided portal hypertension caused by idiopathic splenic vein stenosis, and splenectomy was performed. The postoperative course was smooth, and improvement of the gastric varices was shown by upper gastrointestinal endoscopy at 3 months after the operation.

Conclusions: Idiopathic splenic vein stenosis is an extremely rare cause of left-sided portal hypertension. Splenectomy is one of the most effective treatments for left-sided portal hypertension caused by idiopathic splenic vein stenosis.

Keywords: Idiopathic splenic vein stenosis; Left-sided portal hypertension; Splenectomy.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Fig. 1
Fig. 1
Upper gastrointestinal endoscopy showed isolated varices in the gastric fundus
Fig. 2
Fig. 2
Contrast-enhanced abdominal computed tomography findings. a, b Stenosis (2 mm in diameter, yellow arrows) of almost the entire length of the splenic vein, with post-stenosis dilatation at the splenic hilum (10 mm in diameter, blue arrows). c Development of gastric fundal varices and short gastric veins. d No inflammatory changes around the pancreas or pancreatic neoplasm were observed. a, c, d Axial views. b Blood vessel construction image
Fig. 3
Fig. 3
Upper gastrointestinal endoscopy at 3-months postoperatively showed disappearance of the gastric varices
See this image and copyright information in PMC

References

    1. The aberrant portal hemodynamics study group supported by the Ministry of Health, Labor and Welfare of Japan. Diagnosis and treatment guidelines for aberrant portal hemodynamics (2018). http://www.hepatobiliary.jp/modules/medical/index.php?content_id=14. Accessed 13 Feb 2018. - PubMed
    1. Köklü S, Coban S, Yüksel O, Arhan M. Left-sided portal hypertension. Dig Dis Sci. 2007;52:1141–1149. doi: 10.1007/s10620-006-9307-x. - DOI - PubMed
    1. Madsen MS, Petersen H, Sommer H. Segmental portal hypertension. Ann Surg. 1986;204:72–77. doi: 10.1097/00000658-198607000-00010. - DOI - PMC - PubMed
    1. Moossa AR, Gadd MA. Isolated splenic vein thrombosis. World J Surg. 1985;9:384–390. doi: 10.1007/BF01655272. - DOI - PubMed
    1. Kohno K, Nakata K, Muro T, Furukawa R, Kusumoto Y, Munehisa T, et al. Two cases of gastric varices due to pancreatic pseudocyst. Gastroenterol Endosc. 1981;23:1067–1079.

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