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Citation:
Weerakkody Y, Knipe H, Shah V, et al. Sinistral portal hypertension. Reference article, Radiopaedia.org (Accessed on 26 Jun 2024) https://doi.org/10.53347/rID-72040
Sinistral portal hypertension (also known as left-sided portal hypertension or segmental portal hypertension) is an uncommon form of portal hypertension.
Clinical presentation
Sinistral portal hypertension is most commonly found incidentally in asymptomatic patients. In symptomatic patients, the most common presentation (although rare) is gastrointestinal bleeding from oesophageal or gastric varices 2.
Splenomegaly is common (~70%). Cirrhosis and ascites are not common presenting features 4.
Pathology
Sinistral portal hypertension results from occlusion of the splenic vein, usually from pancreatic pathology (e.g. pseudocyst, carcinoma).
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1. Kokabi N, Lee E, Echevarria C, Loh C, Kee S. Sinistral portal hypertension: presentation, radiological findings, and treatment options - a case report. (2010) Journal of radiology case reports. 4 (10): 14-20. doi:10.3941/jrcr.v4i10.512 - Pubmed
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2. Thompson RJ, Taylor MA, McKie LD, Diamond T. Sinistral portal hypertension. (2006) The Ulster medical journal. 75 (3): 175-7. Pubmed
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3. Singhal D, Kakodkar R, Soin AS, Gupta S, Nundy S. Sinistral portal hypertension. A case report. (2006) JOP : Journal of the pancreas. 7 (6): 670-3. Pubmed
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4. Pereira P, Peixoto A. Left-Sided Portal Hypertension: A Clinical Challenge. (2015) GE Portuguese journal of gastroenterology. 22 (6): 231-233. doi:10.1016/j.jpge.2015.10.001 - Pubmed
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5. Madsen MS, Petersen TH, Sommer H. Segmental portal hypertension. (1986) Annals of surgery. 204 (1): 72-7. doi:10.1097/00000658-198607000-00010 - Pubmed
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