Abstract
Extrahepatic portal hypertension (EPH) is hypertension that occurs in the extrahepatic
portal vasculature in the absence of liver cirrhosis. Portal hypertension (PHTN) is
defined as a pressure gradient between the portal vein and hepatic vein/inferior vena
cava (IVC) exceeding more than 5 mm Hg. PHTN is more commonly known as a manifestation
of cirrhosis and the related elevation in hepatic to venous pressure gradient (HVPG);
however, there are other extrahepatic etiologies to PHTN that are important for review.
Per our literary review, EPH as a complication of pancreatitis has been known as a
manifestation since at least the 1970s. Among the severities of pancreatitis, it occurs
most commonly with acute necrotizing pancreatitis and chronic pancreatitis. In this
review, we plan to provide an understanding of mechanisms by which EPH occurs, discuss
the treatments (e.g., anticoagulation, splenic artery embolization, and splenectomy)
for the complications that result from prolonged EPH, and discuss the current endoscopic
interventions available to counteract these complications.
Keywords
pancreatitis - portal hypertension - splenic vein thrombosis
