Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jul 4;13(7):e16165.
doi: 10.7759/cureus.16165. eCollection 2021 Jul.

Isolated Gastric Variceal Hemorrhage Secondary to Idiopathic Sinistral Portal Hypertension

Mona Abraham  1 , Shreyans Doshi  1 , Mohammad Maysara Asfari  1 , John Erikson L Yap  1 , H Gregory Bowers  2
Affiliations
Case Reports

Isolated Gastric Variceal Hemorrhage Secondary to Idiopathic Sinistral Portal Hypertension

Mona Abraham et al. Cureus. .

Abstract

Sinistral portal hypertension (SPH), also known as left-sided portal hypertension or segmental portal hypertension, is a rare cause of upper gastrointestinal bleeding. Historically, SPH is a result of obstruction of the splenic vein often secondary to pancreatic pathology. To our knowledge, there are no reported cases of idiopathic SPH in which the findings cannot be attributed to any etiology. It is important to do a detailed workup to rule out common pathologies of SPH before making a diagnosis of idiopathic SPH. Treatment of gastric variceal bleed secondary to idiopathic SPH can be challenging and requires a multidisciplinary approach with surgery and interventional radiology. Our patient's history, examination findings, and imaging revealed no identifiable cause for SPH suggesting idiopathic SPH. We describe a case of isolated gastric variceal hemorrhage due to idiopathic SPH that was successfully treated.

Keywords: gastric variceal hemorrhage; gi bleed; isolated gastric varices; left-sided portal hypertension; sinistral portal hypertension; sph; splenic artery embolization; splenic vein thrombosis; ugib; upper gi bleed.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Splenic arteriogram prior to embolization demonstrating gastric varices.
Figure 2
Figure 2. Splenic vein and portal venogram after splenic artery embolization.
Figure 3
Figure 3. Splenic vein and portal venogram after embolization of gastric varices.
See this image and copyright information in PMC

References

    1. Sinistral portal hypertension. A case report. Singhal D, Kakodkar R, Soin AS, Gupta S, Nundy S. https://pubmed.ncbi.nlm.nih.gov/17095850/ JOP. 2006;7:670–673. - PubMed
    1. Left-sided portal hypertension. Köklü S, Coban S, Yüksel O, Arhan M. Dig Dis Sci. 2007;52:1141–1149. - PubMed
    1. Sinistral portal hypertension. Thompson RJ, Taylor MA, McKie LD, Diamond T. https://pubmed.ncbi.nlm.nih.gov/16964806/ Ulster Med J. 2006;75:175–177. - PMC - PubMed
    1. Gastric varices in absence of splenic vein thrombosis: a rare entity of idiopathic non-cirrhotic portal hypertension. Choksi V, Chokshi B, Chu A, Mandale D, Wolfson DL, Kaplan S, Feiz H. Cureus. 2017;9:0. - PMC - PubMed
    1. Role of splenic artery embolization in gastric variceal hemorrhage due to sinistral portal hypertension. Sebastian B, Singhal S, Madhurkar R, Alex A, Uthappa MC. J Clin Interv Radiol. 2019;3:27–36.

Publication types

LinkOut - more resources