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Splenic venous hypertension presenting as variceal hemorrhage caused by portal hypertension.
J Am Coll Surg. 1996 Jan; 182(1):63-8.JA

Abstract

BACKGROUND

Splenic venous hypertension (SVH) may cause variceal hemorrhage that is clinically indistinguishable from similar bleeding caused by portal hypertension (PH). This may lead to erroneous treatment, including inappropriate portosystemic shunt placement.

STUDY DESIGN

A retrospective review of 58 cases of variceal hemorrhage referred for transmesenteric variceal sclerotherapy and transvenous intrahepatic portosystemic shunt (TIPS) placement revealed that seven patients had SVH as a cause of bleeding, and required treatment other than TIPS. The role of medical imaging in the diagnosis and management of SVH was analyzed.

RESULTS

Clinical data did not permit a differential diagnosis between PH and SVH as the cause of bleeding in all cases. Splenic venous hypertension was suspected and then confirmed exclusively by contrast-enhanced computed tomography (CT) and angiography, which are essential for correct patient management.

CONCLUSIONS

Computed tomography should be routinely performed to exclude SVH before TIPS placement. In instances in which CT fails to establish the diagnosis or splenic artery occlusion is considered for patient management, angiography may be used.

Authors+Show Affiliations

Department of Radiology, Westchester County Medical Center, New York Medical College, Valhalla 10595, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8542092

Citation

Rozenblit, G, et al. "Splenic Venous Hypertension Presenting as Variceal Hemorrhage Caused By Portal Hypertension." Journal of the American College of Surgeons, vol. 182, no. 1, 1996, pp. 63-8.
Rozenblit G, Del Guercio LR, Savino J, et al. Splenic venous hypertension presenting as variceal hemorrhage caused by portal hypertension. J Am Coll Surg. 1996;182(1):63-8.
Rozenblit, G., Del Guercio, L. R., Savino, J., Cerabona, T., Policastro, A., & McPhee, M. (1996). Splenic venous hypertension presenting as variceal hemorrhage caused by portal hypertension. Journal of the American College of Surgeons, 182(1), 63-8.
Rozenblit G, et al. Splenic Venous Hypertension Presenting as Variceal Hemorrhage Caused By Portal Hypertension. J Am Coll Surg. 1996;182(1):63-8. PubMed PMID: 8542092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Splenic venous hypertension presenting as variceal hemorrhage caused by portal hypertension. AU - Rozenblit,G, AU - Del Guercio,L R, AU - Savino,J, AU - Cerabona,T, AU - Policastro,A, AU - McPhee,M, PY - 1996/1/1/pubmed PY - 1996/1/1/medline PY - 1996/1/1/entrez SP - 63 EP - 8 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 182 IS - 1 N2 - BACKGROUND: Splenic venous hypertension (SVH) may cause variceal hemorrhage that is clinically indistinguishable from similar bleeding caused by portal hypertension (PH). This may lead to erroneous treatment, including inappropriate portosystemic shunt placement. STUDY DESIGN: A retrospective review of 58 cases of variceal hemorrhage referred for transmesenteric variceal sclerotherapy and transvenous intrahepatic portosystemic shunt (TIPS) placement revealed that seven patients had SVH as a cause of bleeding, and required treatment other than TIPS. The role of medical imaging in the diagnosis and management of SVH was analyzed. RESULTS: Clinical data did not permit a differential diagnosis between PH and SVH as the cause of bleeding in all cases. Splenic venous hypertension was suspected and then confirmed exclusively by contrast-enhanced computed tomography (CT) and angiography, which are essential for correct patient management. CONCLUSIONS: Computed tomography should be routinely performed to exclude SVH before TIPS placement. In instances in which CT fails to establish the diagnosis or splenic artery occlusion is considered for patient management, angiography may be used. SN - 1072-7515 UR - https://www.unboundmedicine.com/medline/citation/8542092/Splenic_venous_hypertension_presenting_as_variceal_hemorrhage_caused_by_portal_hypertension_ L2 - http://www.diseaseinfosearch.org/result/5881 DB - PRIME DP - Unbound Medicine ER -