Abstract
BackgroundSplenic vein stenosis and occlusion, which are known causes of left-sided portal hypertension, often occur secondary to trauma, pancreatitis, or invasion or compression by pancreatic tumors. However, few reports have described idiopathic splenic vein stenosis.Case presentationA 70-year-old man was referred to our hospital for examination of isolated gastric varices. He had no history of liver disease, pancreatitis, or abdominal trauma. Computed tomography revealed stenosis of almost the entire length of the splenic vein, and development of gastric fundal and short gastric varices. No inflammatory changes or neoplastic lesions of the pancreas were observed in any imaging study. The patient was diagnosed with left-sided portal hypertension caused by idiopathic splenic vein stenosis, and splenectomy was performed. The postoperative course was smooth, and improvement of the gastric varices was shown by upper gastrointestinal endoscopy at 3 months after the operation.ConclusionsIdiopathic splenic vein stenosis is an extremely rare cause of left-sided portal hypertension. Splenectomy is one of the most effective treatments for left-sided portal hypertension caused by idiopathic splenic vein stenosis.
Highlights
Splenic vein stenosis and occlusion, which are known causes of left-sided portal hypertension, often occur secondary to trauma, pancreatitis, or invasion or compression by pancreatic tumors
Splenectomy is one of the most effective treatments for left-sided portal hypertension caused by idiopathic splenic vein stenosis
Splenic vein stenosis or occlusion is often caused by trauma, pancreatitis, or invasion or compression by a pancreatic tumor, few reports have described idiopathic splenic vein stenosis
Summary
We report a case of LSPH caused by idiopathic splenic vein stenosis that was improved by splenectomy. There are few reports of idiopathic splenic vein stenosis, and this condition can sometimes be fatal. Splenectomy is one of the most effective treatments for patients with intractable bleeding and recurrence from gastric varices
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