Abstract
A patient with massive splenomegaly secondary to agnogenic myelofibrosis and extramedullary myeloid metaplasia was found to have esophageal varices. No intra- or extrahepatic obstruction to portal blood flow was present. Splenectomy immediately reduced portal venous pressure to normal, and 2 months postoperatively no varices were demonstrable by barium swallow. Portal hypertension in certain cases of agnogenic myelofibrosis and extramedullary myeloid metaplasia may be mainly due to increased portal flow rather than increased resistance, and these individuals may benefit from splenectomy alone.
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