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因胰腺假性囊肿导致的左侧门静脉高压:上消化道出血的罕见病因。

Sinistral Portal Hypertension Due to a Pancreatic Pseudocyst: A Rare Cause of Upper Gastrointestinal Bleeding.

机构信息

Internal Medicine Department, St. Joseph's University Medical Center, Paterson, NJ, USA.

Medical Library Services, St. Joseph's University Medical Center, Paterson, NJ, USA.

出版信息

J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241231644. doi: 10.1177/23247096241231644.

Abstract

Sinistral portal hypertension (SPH), also known as segmental portal hypertension, is a complication of pancreatic disorders and an extremely rare cause of upper gastrointestinal (GI) bleeding. SPH is observed in patients without cirrhosis and arises from splenic vein thrombosis. Unmitigated backflow of blood may cause gastric venous congestion and ultimately GI hemorrhage. Herein, we report a rare case of massive hematemesis due to SPH in a male patient with a history of chronic pancreatitis and pancreatic pseudocyst. Our patient was successfully treated with endoscopic necrosectomy followed by open splenectomy, distal pancreatectomy, and partial gastric resection.

摘要

脾静脉血栓形成导致的门静脉左支高压症(sinistral portal hypertension,SPH),又称节段性门静脉高压症,是胰腺疾病的一种并发症,也是引起上消化道(GI)出血的罕见原因。SPH 可见于无肝硬化的患者,其发病原因是脾静脉血栓形成。血液不受控制地反流会导致胃静脉淤血,最终导致 GI 出血。在此,我们报告一例罕见的男性慢性胰腺炎和胰腺假性囊肿患者因 SPH 导致大量呕血的病例。我们的患者在内镜坏死组织清除术治疗后成功进行了开腹脾切除术、胰体尾切除术和部分胃切除术。

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