A success story of modified Sugiura technique surgery in a non-cirrhotic portal hypertension (NCPH)

Abstract

Background: Non-cirrhotic portal hypertension refers to elevated portal vein pressure in the absence of liver cirrhosis. Surgery could be an effective procedure for patients with recurrent variceal bleeding who fail to respond to pharmacotherapy or endoscopic therapy. We report a success story of modified Sugiura technique in managing a patient with non-cirrhotic portal hypertension. Case presentation: A male, 24-year-old, complained of recurrent vomiting of dark red blood color for six months. Anemic conjunctiva and splenomegaly were discovered during a physical examination. Pancytopenia and normal hepatobiliary function were revealed in the laboratory examination. Ultrasonography of the abdomen demonstrates nonspecific splenomegaly. An abdominal computerized tomography scan revealed hepatosplenomegaly and pelvic fluid accumulations. Grade IV esophageal varices and mild portal hypertensive gastropathy were observed during endoscopic examination. Active bleeding still presented despite initiation of medical treatment and endoscopic ligation. Finally, a surgical procedure using the Sugiura technique was performed. The patient was recovered, no recurrent symptom of hematemesis was reported after one year of follow-up. Conclusion: Modified Sugiura technique is a useful treatment of choice in non-cirrhotic portal hypertension patients who failed to respond other medical treatments. However, comprehensive assessment is critical prior to choose this procedure.