Left-sided portal hypertension is a rare clinical syndrome which may lead to bleeding from isolated gastric varices. Pancreatic disease is the most common etiology. Left-sided portal hypertension should be considered in the presence of gastrointestinal bleeding with normal liver function and unexplained splenomegaly. It may be difficult to diagnose this entity both endoscopically and radiologically. While splenectomy is the treatment of choice for cases complicated by variceal bleeding, there is no consensus on the treatment of asymptomatic patients. The prognosis of left-sided portal hypertension mainly depends on the underlying etiology.
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Article Synopsis
- Solid pseudopapillary neoplasm (SPN) is a low-grade malignant tumor mostly seen in pediatric cases, where spleen preservation during surgery is critical to prevent infection, though complications like left-sided portal hypertension (LSPH) can complicate this.
- A 12-year-old girl diagnosed with SPN had symptoms like abdominal pain and anemia, and imaging revealed a mass in her pancreas along with signs of LSPH, prompting a surgery that initially aimed to preserve the spleen.
- Despite the initial surgery, the patient faced ongoing abdominal pain due to LSPH-related issues, leading to a splenectomy, which resolved her pain and showed no recurrence after eight years.
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