Extrahepatic Portal Hypertension Caused by Chronic Pancreatitis

Of 164 patients with extrahepatic portal hypertension, only 5 had chronic pancreatitis as the only predisposing disease. Four of the five had bleeding from esophagogastric varices, and all five had splenomegaly. Previous splenoportographic studies have shown that partial or total portal system obstruction occurs frequently in chronic pancreatitis, but symptomatic portal hypertension is much less common. Gastrointestinal bleeding and splenomegaly with chronic pancreatitis should alert the physician to the possibility of extrahepatic portal hypertension and varices. If the obstruction is confined to the splenic vein, splenectomy is the treatment of choice.