【摘要】 目的总结胰源性左侧肝外门静脉高压症(LEPH)临床特点、诊断和治疗经验。方法回顾性分析我院收治的8例 LEPH 病人临床资料。结果 LEPH 主要表现为黑便、呕血和脾肿大、脾功能亢进,并有胰腺炎、胰腺肿瘤或胰腺外伤表现,而无肝脏疾病表现,内镜下以孤立性胃底静脉曲张为主。术前易误诊为肝硬化门脉高压症。本组病例中行单纯脾切除2例,脾切除+胰体尾切除术5例,脾动脉结扎1例。结论胰腺疾病可致门静脉高压症,脾静脉栓塞是本病直接原因。胰腺疾病合并上消化道出血应想到本症可能,脾切除术可有效控制出血。更多还原

【Abstract】 Objective To summarize the experience in diagnosis and treatment of left-sided ex- trahepatic portal hypertension(LEPH).Methods The clinical data of 8 patients with LEPH treated in our hospital were retrospectively analyzed.Results The patients mainly presented with melena, hematemesis,splenomegaly and hypersplenism,had history of pancreatitis,pancreatic tumors or trau- mas but had no signs of hepatic disease.Isolated gastric fundal varices was the feature of endoscopic findings.LEPH was often misdiagnosed as cirrhotic portal hypertension.Two patients were treated by splenectomy,5 by distal pancreatectomy plus splenectomy and 1 by splenic artery ligation.Conclu- sions Portal hypertension can be caused by pancreatic diseases.The splenic vein thrombosis is the di- rect reason for LEPH.LEPH should be suspected in case of pancreatic diseases associated with upper digestive tract hemorrhage.Splenectomy can effectively control the bleeding.更多还原