Segmental portal hypertension

Česká verzia

Authors: Ľ. Mihalkanin
Authors place of work: Gastroenterologická ambulancia, Nemocnica Svidník n. o.
Published in the journal: Gastroent Hepatol 2013; 67(1): 58-64
Category: Hepatology: Review article

Summary

Segmental portal hypertension (SPH) results from the isolated splenic vein obstruction (VL) in the presence of normal blood flow in portal and upper mesenteric vein, without affecting liver. Similarly to portal hypertension, also in patients with segmental portal hypertension the blood flowing into the spleen is fed back into the portal blood stream through the collateral circulation. They form gastric varices (GV) (mainly isolated (IGV)). Their bleeding is the most common, sometimes life-threatening manifestation of SPH. Although segmental portal hypertension has some common features with portal hypertension (especially pre-hepatic – creation of collateral circulation, formation of gastroesophageal varices), there are some significant differences between treatment and prognosis of the patient. Therefore, it is important to think of this rare diagnosis in patients with bleeding in the upper gastrointestinal tract, especially in those with pancreatic diseases, and to treat it accordingly.

Key words:
portal hypertension – esophageal and gastric varices – splenic vein – obstruction

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
16. 11. 2012

Accepted:
6. 2. 2013

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