Incidence of portal hypertension in patients exposed to oxaliplatin

Oxaliplatin is an alkylating agent used for gastrointestinal neoplasia [1]. Case descriptions showed that oxaliplatin may lead to the development of portal hypertension (PH) [2–4] with histological alterations similar to those found in idiopathic non-cirrhotic portal hypertension (NCPH). We observed 4 patients with NCPH secondary to oxaliplatin. Their clinical features on disease evolution are reported in Table 1. To establish the incidence and presentation of NCPH we reviewed the database of patients consecutively treated with oxaliplatin. Five hundred and seven patients admitted to the Oncology Unit between January 2011 and March 2017 and treated with oxaliplatin for gastrointestinal neoplasia were reviewed (Fig. 1). Among them, 347 were excluded because of CT scans not performed at our Radiology Unit and 80 because of signs of PH before therapy or for the presence of other conditions potentially related to PH. Four patients were excluded because affected by some conditions potentially associated with NCPH (celiac disease, IBD and AIDS) and 13 patients had a history of abdominal surgery potentially causing thrombosis and PH. Finally, 14 patients were excluded because of contemporaneous presence of portal vein diameter > 15 mm and longitudinal spleen diameter > 12 cm and 11 because of ascites in the CT scan performed before oxaliplatin.