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Abstract

Introduction: Sinistral Portal Hypertension (SPH), also referred to as left-sided portal hypertension, is a relatively uncommon medical condition characterized by an isolated blockage in the splenic vein. This obstruction leads to elevated venous pressure within the splenic bed and the development of gastric varices. SPH primarily manifests as a consequence of underlying pancreatic disorders, and its clinical presentation commonly includes hypersplenism and gastrointestinal variceal hemorrhage. Patients often initially present with symptoms resembling pancreatitis, which prompts the performance of diagnostic imaging, such as a CT scan, revealing the presence of SPH.

Case presentation: In this case report, we present the clinical scenario of a 42-year-old female who has a documented history of diabetes mellitus. She sought medical attention in the emergency room due to the complaint of severe epaigastric pain radiating to her back. Initial clinical assessment raised suspicions of pancreatitis, prompting the utilization of a CT scan of the abdomen to further investigate her condition. The imaging findings in this case notably confirmed the presence of Sinistral Portal Hypertension (SPH).

Conclusion: Distinguishing SPH from generalized portal hypertension is of paramount importance due to the distinct treatment approaches associated with each condition. This study primarily aims to elucidate the characteristic CT imaging features of SPH and explore its clinical aspects, highlighting the need for accurate diagnosis and tailored management strategies in cases of this relatively rare yet clinically significant condition.

Keywords: Sinistral hypertension; Portal hypertension; Gastric varices; CT scan; Left sided; Splenic vien occlusion