Collateral Circulation of the Splenoportal System in Portal Hypertension

1993 ◽  
pp. 330-341
Author(s):  
H.-J. Maurer
Keyword(s):  
Portal Hypertension ◽  
Collateral Circulation

scholarly journals The Role of Endoscopic Ultrasound for Esophageal Varices

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1007
Author(s):  
Kazunori Nagashima ◽  
Atsushi Irisawa ◽  
Keiichi Tominaga ◽  
Ken Kashima ◽  
Yasuhito Kunogi ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Effective Treatment ◽  
Endoscopic Ultrasound ◽  
Esophageal Varices ◽  
Collateral Circulation ◽  
Preventive Treatment ◽  
Esophagogastric Varices ◽  
Indispensable Tool

Esophageal varices are caused by the development of collateral circulation in the esophagus as a result of portal hypertension. It is important to administer appropriate preventive treatment because bleeding varices can be fatal. Esophageal varices have complex and diverse hemodynamics, and there are various variations for each case. Endoscopic ultrasound (EUS) can estimate the hemodynamics of each case. Therefore, observation by EUS in esophageal varices provides useful information, such as safe and effective treatment selection, prediction of recurrence, and appropriate follow-up after treatment. Although treatment for the esophagogastric varices can be performed without EUS imaging, understanding the local hemodynamics of the varices using EUS prior to treatment will lead to more safe and effective treatment. EUS observation is an indispensable tool for thorough variceal care.

Spleno-renal shunt blood flow is an accurate index of collateral circulation in different models of portal hypertension and after pharmacological changes in rats

2000 ◽  
Vol 32 (3) ◽  
pp. 434-440 ◽  
Author(s):  
Nary Veal ◽  
Frédéric Oberti ◽  
Frédéric Moal ◽  
Eric Vuillemin ◽  
Joël Fort ◽  
...  
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Collateral Circulation

scholarly journals Duplex sonography study in schistosomiasis portal hypertension: characterization of patients with and without a history of variceal bleeding

2008 ◽  
Vol 45 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Severino Marcos Borba de Arruda ◽  
Victorino Spinelli Toscano Barreto ◽  
Fernando José do Amaral
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Variceal Bleeding ◽  
Collateral Circulation ◽  
Past History ◽  
Duplex Sonography ◽  
Group I ◽  
History Of ◽  
Group Ii ◽  
Upper Gastrointestinal

BACKGROUND: Presinusoidal portal hypertension with frequent episodes of upper gastrointestinal variceal bleeding are hallmarks of hepatosplenic Manson’s schistosomiasis; a clinical form that affects about 5% of Brazilians who are infected by Schistosoma mansoni. AIMS: To evaluate duplex sonography findings in patients with hepatosplenic Manson’s schistosomiasis with and without upper gastrointestinal variceal hemorrhage. METHODS: A cross-sectional study was performed whereby 27 consecutive patients with hepatosplenic Manson’s schistosomiasis were divided into two groups: group I (six men and six women; mean age 48.7 years) with a past history of bleeding and group II (four men and eight women; mean age 44.7 years) without a past history of upper gastrointestinal bleeding, underwent duplex sonography examination. All patients underwent the same upper gastrointestinal endoscopy and laboratory examinations. Those with signs of mixed chronic liver disease or portal vein thrombosis (three cases) were excluded. RESULTS: Group I showed significantly higher mean portal vein flow velocity than group II (26.36 cm/s vs 17.15 cm/sec). Although, as a whole it was not significant in all forms of collateral vessels (83% vs 100%), there was a significantly higher frequency of splenorenal collateral circulation type in group II compared with group I (17% vs 67%). The congestion index of the portal vein was significantly lower in group I than in group II (0.057 cm vs 0.073 cm/sec). CONCLUSION: Our duplex sonography findings in hepatosplenic Manson’s schistosomiasis support the idea that schistosomotic portal hypertension is strongly influenced by overflow status, and that collateral circulation seems to play an important role in hemodynamic behavior.

scholarly journals Heterotopic Auxiliary Liver Transplantation with Portal Flow

HPB Surgery ◽  
1990 ◽  
Vol 2 (4) ◽  
pp. 281-293 ◽  
Author(s):  
Laureano Lorente ◽  
Jaime Arias ◽  
Maria Angeles Aller ◽  
José Ignacio Ispizua ◽  
José Rodriguez ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Portal Hypertension ◽  
Experimental Model ◽  
Collateral Circulation ◽  
Host Liver ◽  
Portal Flow ◽  
Bile Duct Proliferation ◽  
Gradual Development ◽  
Auxiliary Liver Transplantation ◽  
Severe Degree

One of the causes of auxiliary liver transplantation failure is the inter-liver competition between the host liver and the graft for the hepatotrophic factors of the portal blood. We have developed an experimental model of heterotopic partial (30%) liver isotransplant using Wistar rats so as to study this competition.Splenoportography and dissection demonstrate the existence of collateral circulation. The collaterals at 90 days post-transplant (PT) consisted of veins from the portal vein to the host liver (PR), paraesophageal veins (PE) and splenorenal veins (SR). At 60 days P.T., PR and SR veins but not PE ones appeared, and at 30 days P.T., there were only PR veins. Graft atrophy at 90 days P.T. was associated with a severe degree of bile duct proliferation.The gradual development of portal hypertension causes porto-systemic collateral circulation and the graft loses the portal hepatotrophic factors. The late development of the portal hypertension and the biliary proliferation could be caused by the hepatic arterial ischemia in this experimental model. Thus, as has been described in the orthotopic liver tansplantation, the heterotopic one might require a double vascularization, both portal and arterial.

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