左侧门静脉高压的临床和内镜特征

The clinic and endoscopic features of left-sided portal hypertension

目的 探讨左侧门静脉高压的临床特点和内镜特征。方法 对手术证实的8例左侧门静脉高压患者的临床资料进行回顾性分析。结果 左侧门静脉高压的临床表现主要为呕血、黑便和脾大、脾功能亢进,患者具有胰腺疾病的特点,而无肝脏疾病的表现和检查异常。内镜下以孤立性胃底静脉曲张为主,占62.5％;食管、胃底静脉同时曲张占37.5％。术前易误诊为血液系统疾病和肝硬化门静脉高压。结论 胰腺疾病可致门静脉高压,孤立性胃底静脉曲张是左侧门静脉高压的的特征性表现之一。

Objective To investigate the clinic and endosoopic features of left-sided portal hypertension ( LSPH). Methods Eight patients with left-sided portal hypertension were analyzed retrospectively. Results The main manifestations of patients with LSPH were hematemesis, hematochezia, splenomegaly and hypersplenism. The patients have the features of pancreatic disease, but without the evidences of hepatic disease. Solitary gastric varices account for 62. 5% , both gastric and esophageal varices account for 37. 5% . The patients with features of LSPH often mislead to diagnose as blood diseases or portal hypertension resulted from hepatic cirrhosis. Conclusions Pancreatic diseases may lead to portal hypertension, solitary gastric varices were the important evidence of left-sided portal hypertension.