By U. Yun Ryo, Abass Alavi, B. David Collier, Carlos Bekerman, st Pinsky
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1974;111:47–51. 10. Kayser S, Narincek B, Schlumpf R, Fried M, Wirth HP. Rapidly progressive portal hypertension 23 years after post-traumatic arterioportal fistula of the liver. Am J Gastroenterol. 1996;91:1442–1446. 11. Ohnishi K, Masayuki S, Sato S, et al. Portal hemodynamics in idiopathic portal hypertension (Bandi’s syndrome) comparison with chronic persistent hepatitis and normal subjects. Gastroenterology. 1987;92:751–758. 12. Garcia-Palmieri MR, Marcial-Rojas RA. Portal hypertension due to Schistosomiasis mansoni.
10 SECTION 1 Portal Hypertension FIGURE 2–3. Cavernous transformation of the portal vein (open arrow) with splenic vein thrombosis in patient with polycythemia rubra vera. Note the hepatofugal flow in the left coronary vein (black arrow) and inferior mesenteric vein (white arrow). FIGURE 2–5. Spontaneous splenorenal shunt in patient with hepatic cirrhosis secondary to biliary atresia. The portal venous phase of the superior mesenteric artery arteriogram demonstrates hepatofugal flow in the left coronary vein (arrow) with filling of the left renal vein (open arrow) and inferior vena cava (dotted arrow).
A less common means of portal vein decompression involves the development of middle and right colic to portal vein collaterals or direct superior mesenteric vein to inferior vena cava shunts (veins of Retzius) (Fig. 2–4). 15,16 In cases of spontaneous splenorenal shunts (Fig. 15,16 This shunt would appear to afford no significant protection against variceal hemorrhage. Other Forms of Presinusoidal Extrahepatic Portal Hypertension FIGURE 2–4. Portal hypertension secondary to hepatitis Cinduced cirrhosis.
Atlas of Nuclear Medicine Artifacts and Variants by U. Yun Ryo, Abass Alavi, B. David Collier, Carlos Bekerman, st Pinsky