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
BACKGROUND Sinusoidal obstruction syndrome has been reported after oxaliplatin-based chemotherapy,but liver fibrosis and non-cirrhotic portal hypertension(NCPH)are rarely reported.CASE SUMMARY Here,we describe the cas...BACKGROUND Sinusoidal obstruction syndrome has been reported after oxaliplatin-based chemotherapy,but liver fibrosis and non-cirrhotic portal hypertension(NCPH)are rarely reported.CASE SUMMARY Here,we describe the case of a 64-year-old woman who developed isolated gastric variceal bleeding 16 mo after completing eight cycles of oxaliplatin combined with capecitabine chemotherapy after colon cancer resection.Surprisingly,splenomegaly and thrombocytopenia were not accompanied by variceal bleeding,which has been reported to have predictive value for gastric variceal formation.However,a liver biopsy showed fibrosis in the portal area,suggesting NCPH.The patient underwent endoscopic treatment and experienced no further symptoms.CONCLUSION It is necessary to guard against long-term complications after oxaliplatin-based chemotherapy.Sometimes splenic size and platelet level may not always accurately predict the occurrence of portal hypertension.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.
基金Supported by Tianjin Science and Technology Plan Project,No.19ZXDBSY00030。
文摘BACKGROUND Sinusoidal obstruction syndrome has been reported after oxaliplatin-based chemotherapy,but liver fibrosis and non-cirrhotic portal hypertension(NCPH)are rarely reported.CASE SUMMARY Here,we describe the case of a 64-year-old woman who developed isolated gastric variceal bleeding 16 mo after completing eight cycles of oxaliplatin combined with capecitabine chemotherapy after colon cancer resection.Surprisingly,splenomegaly and thrombocytopenia were not accompanied by variceal bleeding,which has been reported to have predictive value for gastric variceal formation.However,a liver biopsy showed fibrosis in the portal area,suggesting NCPH.The patient underwent endoscopic treatment and experienced no further symptoms.CONCLUSION It is necessary to guard against long-term complications after oxaliplatin-based chemotherapy.Sometimes splenic size and platelet level may not always accurately predict the occurrence of portal hypertension.
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.
