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Upper gastrointestinal bleeding due to left side portal hypertension after pancreatic surgery |
Pierre Mayer a , b , ∗, Emanuele Felli b , c , d , Iulian Enescu e , François Habersetzer a , b , d , Simona Tripon a , b , d |
a Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
b Institut Hospitalo-universitaire (IHU) de Strasbourg, Pôle Hépato-digestif, Strasbourg, France
c Department of Hepato-biliary and Pancreatic surgery, Pôle Hépato-digestif, Nouvel Hôpital Civil, HUS, Strasbourg, France
d Institut des Maladies Virales et Hépatiques, Inserm U1110, Université de Strasbourg, Faculté de Médecine, Strasbourg, France
e Department of Interventional Radiology, Pôle d’imagerie, Nouvel Hôpital Civil, HUS, Strasbourg, France
∗ Corresponding author at: Service d’Hépato-gastroentérologie, Pôle Hépatodigestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg 1, place de l’hôpital 67000 Strasbourg, France.
E-mail address: pierre-emmanuel.mayer@chru-strasbourg.fr (P. Mayer). |
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Abstract Left-side portal hypertension (LSPH) is a rare cause of intraabdominal venous hypertension. In most of cases, LSPH is due to pancreatic diseases, especially chronic pancreatitis, but it is also described in other abdominal diseases (i.e., retroperitoneal fibrosis or perineal abscess) after abdominal surgery (i.e., pancreatic surgery, liver transplantation) or endovascular procedures [1–4]. Notably, LSPH was described for the first time by Greenwald and Wasch in 1939 [5]. Unlike generalized portal hypertension frequently observed in chronic liver disease, patients with LSPH have normal liver function. However, they can develop esophageal and/or gastric varices [1,2,6]. The incidence of LSPH remains unknown but it seems gradually increased in recent years especially due to higher sensitivity of current imaging techniques and increased knowledge in pancreatic disorders. Most of the time LSPH is an asymptomatic condition, but in some case, it can present with chronic abdominal pain or upper gastrointestinal variceal bleeding (UGIVB).
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