Left-Sided Portal Hypertension: a Case Series

Left-sided portal hypertension is rarely found, but this condition may cause gastrointestinal tract bleeding and can be life-threatening. The exact incidence of left-sided portal hypertension is unknown as it is rarely found, approximately 1-5%, and most cases were misdiagnosed. We reported 3 cases of left-sided portal hypertension in male patient aged 34 years old, female patient aged 29 years old, and female patient aged 35 years old. Most diagnosis was made based on the clinical findings by excluding the diagnosis of cirrhotic portal hypertension. Splenic vein angiography remains the gold standard in diagnosing left sided portal hypertension. Left-sided portal hypertension is difficult to differentiate from cirrhotic portal hypertension because in these both abnormalities, varices can be present. Left-sided portal hypertension can be considered as a diagnosis in patient with upper gastrointestinal tract bleeding due to oesophageal varices, gastric varices, or portal hypertension gastropathy, accompanied with hypersplenism without the presence of hepatic abnormality or cirrhosis

Acupuncture in the Management of Functional Dyspepsia

Dyspepsia is an uncomfortable sensation or pain in the upper abdomen which is persisting or recurring. Dyspepsia can be classified into functional and organic dyspepsia. Functional dyspepsia is more commonly found compared to the organic type, approximately 60%. Pharmacologic therapy in the management of functional dyspepsia has not shown optimal results, with the multifactorial etiology of functional dyspepsia as the main challenge. Therefore, the management of functional dyspepsia is widened and involves variety treatment modalities, acupuncture being one of them. Acupuncture is a way of treatment by puncturing needles to particular area on the skin to eliminate pain and treat particular diseases. Acupuncture affects stomach motility and gastric acid secretion in functional dyspepsia patients. Two acupuncture points commonly used in functional dyspepsia are ST 36 and PC 6. Acupuncture can restore gastric motility in patients with functional dyspepsia, who have gastric emptying disturbance. Besides, functional dyspepsia complaints, such as epigastric pain, nausea, vomiting, anorexia, burning sensation, and bloating were found to improve after acupuncture therapy. Side effects of acupuncture are not life threatening with low incidence rate. The effectiveness of acupuncture therapy compared to standard medication shows varies results. Further studies are needed to determine the characteristics of functional dyspepsia patients which could have optimal results through acupuncture therapy