Management of Left Portal Hypertension

Treatment Options

• The American College of Gastroenterology recommends legatura endoscopica delle varici (EBL) as the first line of treatment for bleeding varices, with high success rates 1
• The American Association for the Study of Liver Diseases suggests that non-selective beta-blockers, such as propranololo, can be used to reduce portal pressure and improve outcomes in patients with portal hypertensive gastropathy 1
• The European Association for the Study of the Liver recommends that vasoactive therapy be used in the acute setting, while beta-blockers are recommended for chronic management of portal hypertension 2
• Correction of underlying prothrombotic conditions is important in cases of extrahepatic portal vein obstruction, as recommended by the American College of Cardiology 3
• Regular endoscopic monitoring is necessary to evaluate treatment response and identify variceal recurrence early, as suggested by the American Society for Gastrointestinal Endoscopy 4
• Imaging studies, such as Doppler ultrasound or CT, should be used to assess splenic vein patency after recanalization, as recommended by the Society of Interventional Radiology 3