Extra Hepatic Portal Vein Obstruction with Solitary Left Kidney: A Case Report

Akash Chitrakar,Bikal Ghimire,Nirajan Regmi,Pabitra Adhikari,Yogendra P Singh

doi:10.31729/jnma.4214

Abstract

Extra Hepatic Portal Vein Obstruction in individual with solitary left kidney is rare occurence. Though there is no etiological association between Extra Hepatic Portal Vein Obstruction and solitary left kidney but the solitary left kidney decides the modality of treatment. Eighteen year lady referred to our institute with menorrhagia for 5 years and ultrasonography finding of splenomegaly and atretic right kidney. Investigations revealed Extra Hepatic Portal Vein Obstruction with multiple cavernoma formation with oesophagogastric varices with right renal agenesis. She successfully underwent splenectomy with devascularisation. Patient with Extra Hepatic Portal Vein Obstruction present mainly with recurrent episodes of variceal bleeding, splenomegaly and hypersplenism. Splenectomy and esophagogastric devascularisation is an effective modality of treatment for patient with Extra Hepatic Portal Vein Obstruction with solitary kidney. Keywords: cavernoma; modified Hassab's operation; Portal vein; unilateral renal agenesis.

Highlights

Extra hepatic portal vein obstruction (EHPVO) is a vascular disorder which results in obstruction and cavernomatous transformation of portal vein with or without involvement of intrahepatic portal vein, splenic vein or superior mesenteric vein.[1]
Eighteen year female with complains of menorrhagia for 5 years was referred to our center with ultrasonography finding of splenomegaly
Contrast enhanced CT scan of abdomen revealed nonvisusalization of portal vein replaced with cavernoma formation (Figure 2) along with gastric, esophageal, peripancreatic and pericholecystic varices (Figure 1, 2 and 3) and gross splenomegaly (Figure 3) with atretic right kidney (Figure 1)

Summary

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Pabitra Adhikari,[1] Nirajan Regmi,[1] Akash Chitrakar,[1] Bikal Ghimire,[1] YP Singh1 1Department of GI and General Surgery, Institute of Medicine, Maharajgunj, Kathmandu, Nepal

INTRODUCTION

Massive Splenomegaly

Portal vein replaced with cavernomas

DISCUSSION