SINISTRAL PORTAL HYPERTENSION

Sinistral portal hypertension is a rare condition, which produce isolated gastric varices and upper gastrointestinal bleeding. It is due to splenic vein thrombosis which is often secondary to pancreatic disease (inflammations, tumors). Initial treatment is conservative. After successful conservative treatment early surgery should be considered. UGI Scopy, liver function tests, USG abdomen (with Doppler) and CECT or CT Angiogram are the investigations necessary for the diagnosis. Splenectomy absolutely eliminates the risk from gatric rebleeding. Prognosis depends on the etiology of pancreatic disease. We present a case of 37 year old man who was successfully treated with splenectomy for gastric bleeding caused by Sinistral portal hypertension followed by a literature review of the reported causes, pathophysiology and management of Sinistral portal hypertension.