LAUSR

Sinistral portal hypertension (SPH) or left-sided portal hypertension occurs as a result of isolated obstruction of the splenic vein. In the majority of the cases, it is a complication of a pancreatic pathology [1,2]. In contrast to generalized portal hypertension, in patients with SPH, liver function tests and portal vein pressure are within normal limits. Expected flow direction in portal vein is hepatopetal [3e6]. Splenic vein occlusion (SVO) leads to splenic venous congestion, which can cause splenomegaly and splenoportal collateral vessels develop in order to drain blood beyond the occluded splenic vein [7e9]. Owing to anatomic variants of venous anatomy, to underlying causative pathology and to site and duration of the disease, the observed collateral route varies among patients with splenic vein obstruction [10,11]. It has been reported that patients with SPH are usually asymptomatic and experience no complications; hence, the true incidence of this syndrome is unknown [12,13]. Symptomatic patients may present with acute or chronic gastrointestinal bleeding, abdominal pain, or chronic anemia [13,14]. Diagnosis of this disease is made by exclusion of generalized portal hypertension and should be considered in patients with upper gastrointestinal bleeding, normal liver function test results, and splenomegaly [1]. However, with improvement in diagnostic imaging procedures, recognition of SPH seems to be increasing even in asymptomatic patients. Computed tomography (CT) is the imaging technique of choice to diagnose pancreatic pathologies, which are the