Left-sided Portal Hypertension
22 March 2018 (online)
Introduction Left-sided portal hypertension (LSPH) is an uncommon entity, accounting for <5% of all patients with portal hypertension. LSPH should be considered in patients with esophagogastric bleeding and splenomegaly with normal liver function tests. LSPH is most commonly asymptomatic; however, clinically, a majority of symptomatic cases first present with acute massive or chronic upper gastrointestinal (UGI) bleeding from ruptured varices. This exhibit will discuss the incidence, etiology, clinical presentation, and examples of outcomes of LSPH.
Discuss prevalence and causes of LSPH
Pathophysiology of LSPH: with and without splenic vein thrombosis
Different interventional radiology treatment options: splenic artery embolization, balloon-occluded retrograde transvenous obliteration (BRTO), and transjugular intrahepatic portosystemic shunt (TIPS)
Institutional experience with case presentation
Learning Points LSPH is an uncommon entity, which can occur in the presence or absence of splenic vein thrombosis. These are typically asymptomatic, however can present with catastrophic UGI bleeding from ruptured varices. Multi-disciplinary involvement is required for optimal management.