CT scan findings in addition to normal lactic acid levels, lack of significant gastrointestinal symptoms, and relatively benign abdominal examination excluded the more common intestinal pathologies leading to HPVG such as ischemia, diverticulitis, and inflammatory bowel disease.
HPVG is a sign that denotes a life-threatening condition but does not necessarily indicate a need for surgical intervention .
We describe another case of HPVG that is associated with peptic ulcer disease in which we hypothesize that the ulcer might have allowed the entrance of luminal gas and fungus into an enlarged mesenteric varix.
Octreotide also may be helpful in the chronic treatment of portal hypertension as a significant reduction in HPVG occurs after three once-a-month intramuscular injections of the long-acting drug (Spahr et al., 2007).
A significant reduction of HPVG occurs with intravenous bolus administration of somatostatin and its analogues.
When these vasodilating agents are administered to patients for 7 days or more, average HPVG reduction of 17% is achieved (Villanueva & Balanzo, 2008).
Previous research found nitroglycerin provided an additive HPVG reduction effect while avoiding development of deleterious adverse effects when combined with vasopressin therapy (Minano & Garcia-Tsao, 2010).