BACKGROUND Sinistral portal hypertension associated with pancreatic pseudocysts is rare,often caused by extrinsic compression of splenic vein,the follow-up examinations by ultrasonography for early diagnosis are quiet...BACKGROUND Sinistral portal hypertension associated with pancreatic pseudocysts is rare,often caused by extrinsic compression of splenic vein,the follow-up examinations by ultrasonography for early diagnosis are quietly necessary since haematemesis,a life-threatening condition.Few studies have reported the ultrasonography findings of sinistral portal hypertension.CASE SUMMARY A 52-year-old man presented with acute abdominal pain after drinking,steatorrhea,weight loss and accidentally melena in the past 2 mo.He underwent ultrasound-guided fine needle aspiration in other hospital and diagnosed with pancreatic pseudocysts.Ultrasonography imaging,in our department,appeared as cystic heterogeneous hypoechoic area with the size of 4.7 cm×3.8 cm that located posterior to the body and tail of pancreas,adjacent to splenic vein associated with thrombosis resulted from compression.Spleen incrassated to approximately 7.3 cm,but no dilation of main portal vein was presented.Color Doppler Flow Imaging demonstrated the formation of splenic venous collateral,nevertheless no significantly flow signals was observed in splenic vein.Pulsed Doppler revealed that the peak velocity of splenic venous collateral was 18.4 cm/s with continuous waveform.Laparotomy confirmed sinistral portal hypertension associated with pancreatic pseudocysts,subsequently distal pancreatectomy combined with splenectomy and partial gastrectomy was performed.CONCLUSION It’s important clinically to know the ultrasound appearance of sinistral portal hypertension associated with pancreatic pseudocysts for sonographer and physician.展开更多
Sinistral portal hypertension （SPH） is usually caused by pancreatic pathology and is characterized bysplenic vein thrombosis with or without portal vein thrombosis.1 The increased pressure caused by splenic vein occ...Sinistral portal hypertension （SPH） is usually caused by pancreatic pathology and is characterized bysplenic vein thrombosis with or without portal vein thrombosis.1 The increased pressure caused by splenic vein occlusion is transmitted via the short gastric and gastroepiploic veins to the portal system. The reversal of blood flow in the left gastric vein results in gastric varices. In patiems with SPH, especially those with occlusion of both the splenic and portal veins, the main or even the only pathway of splenic venous return to the portal vein is via the gastric varices, and these patiems require special management during gastric surgery.展开更多
Splenic venous hypertension or left-sided portal hypertension is a rare condition caused by an obstruction of the splenic vein.Usually,it presents with upper gastrointestinal bleeding in the absence of liver disease.E...Splenic venous hypertension or left-sided portal hypertension is a rare condition caused by an obstruction of the splenic vein.Usually,it presents with upper gastrointestinal bleeding in the absence of liver disease.Etiologies can be classified based on the mechanism of development of splenic vein hypertension:compression,stenosis,inflammation,thrombosis,and surgically decreased splenic venous flow.Diagnosis is established by various imaging modalities and should be suspected in patients with gastric varices in the absence of esophageal varices,splenomegaly,or cirrhosis.The management and prognosis vary depending on the underlying etiology but generally involve reducing splenic venous pressure.The aim of this review was to summarize the etiologies of splenic venous hypertension according to the mechanism of development.展开更多
文摘BACKGROUND Sinistral portal hypertension associated with pancreatic pseudocysts is rare,often caused by extrinsic compression of splenic vein,the follow-up examinations by ultrasonography for early diagnosis are quietly necessary since haematemesis,a life-threatening condition.Few studies have reported the ultrasonography findings of sinistral portal hypertension.CASE SUMMARY A 52-year-old man presented with acute abdominal pain after drinking,steatorrhea,weight loss and accidentally melena in the past 2 mo.He underwent ultrasound-guided fine needle aspiration in other hospital and diagnosed with pancreatic pseudocysts.Ultrasonography imaging,in our department,appeared as cystic heterogeneous hypoechoic area with the size of 4.7 cm×3.8 cm that located posterior to the body and tail of pancreas,adjacent to splenic vein associated with thrombosis resulted from compression.Spleen incrassated to approximately 7.3 cm,but no dilation of main portal vein was presented.Color Doppler Flow Imaging demonstrated the formation of splenic venous collateral,nevertheless no significantly flow signals was observed in splenic vein.Pulsed Doppler revealed that the peak velocity of splenic venous collateral was 18.4 cm/s with continuous waveform.Laparotomy confirmed sinistral portal hypertension associated with pancreatic pseudocysts,subsequently distal pancreatectomy combined with splenectomy and partial gastrectomy was performed.CONCLUSION It’s important clinically to know the ultrasound appearance of sinistral portal hypertension associated with pancreatic pseudocysts for sonographer and physician.
文摘Sinistral portal hypertension （SPH） is usually caused by pancreatic pathology and is characterized bysplenic vein thrombosis with or without portal vein thrombosis.1 The increased pressure caused by splenic vein occlusion is transmitted via the short gastric and gastroepiploic veins to the portal system. The reversal of blood flow in the left gastric vein results in gastric varices. In patiems with SPH, especially those with occlusion of both the splenic and portal veins, the main or even the only pathway of splenic venous return to the portal vein is via the gastric varices, and these patiems require special management during gastric surgery.
文摘Splenic venous hypertension or left-sided portal hypertension is a rare condition caused by an obstruction of the splenic vein.Usually,it presents with upper gastrointestinal bleeding in the absence of liver disease.Etiologies can be classified based on the mechanism of development of splenic vein hypertension:compression,stenosis,inflammation,thrombosis,and surgically decreased splenic venous flow.Diagnosis is established by various imaging modalities and should be suspected in patients with gastric varices in the absence of esophageal varices,splenomegaly,or cirrhosis.The management and prognosis vary depending on the underlying etiology but generally involve reducing splenic venous pressure.The aim of this review was to summarize the etiologies of splenic venous hypertension according to the mechanism of development.
