Sinistral portal hypertension (SPH), also known as left-sided portal hypertension or
segmental portal hypertension, is a rare cause of upper gastrointestinal bleeding.
Historically, SPH is a result of obstruction of the splenic vein often secondary to pancreatic
pathology. To our knowledge, there are no reported cases of idiopathic SPH in which the
findings cannot be attributed to any etiology. It is important to do a detailed workup to rule
out common pathologies of SPH before making a diagnosis of idiopathic SPH. Treatment of …

DISCUSSION: SPH is a localized form of portal hypertension and is an important cause of
potentially life threatening UGIB. 1 Most commonly, it is secondary to pancreatitis,
malignancy, splenic vein thrombosis and retroperitoneal fibrosis. 2 Our patient was unique
as there were gastric varices without an identifiable cause. SAE is an effective treatment
method, theoretically akin to splenectomy, blocking the direct arterial inflow to the spleen
and thereby reducing the outflow venous pressure.