Acquired portosystemic collaterals: anatomy and imaging

Leite, Andréa Farias de Melo; Mota, Américo; Chagas-Neto, Francisco Abaeté das; Teixeira, Sara Reis; Elias, Jorge; Muglia, Valdair Francisco

doi:10.1590/0100-3984.2015.0026

Cited by 9 publications

(11 citation statements)

References 15 publications

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“…The celiac trunk emerges from just below the aortic hiatus at the level of the transition from the thoracic vertebrae to the lumbar vertebrae. In the so-called "normal" anatomical pattern, the celiac trunk trifurcates (into the splenic artery, common hepatic artery, and left gastric artery) slightly below the point at which it emerges from the aorta 4 , 6 - 11 .…”

Section: Introductionmentioning

confidence: 99%

“…For example, one important application that requires a detailed knowledge of the vascular anatomy is the infusion of chemotherapy via catheter for the treatment of unresectable malignant liver tumors. Laparoscopic surgery can be understood as a model of the importance of recognizing vascular variations in order to avoid iatrogenic complications, given that the surgical field is limited 11 , 13 , 14 , 16 , 18 - 22 .…”

Section: Introductionmentioning

confidence: 99%

“…As it evolved, CT began to allow the acquisition of a greater quantity of computerized images in a shorter period of time, through the use of scanners with multiple rows of submillimeter detectors. Thus, CT facilitated the acquisition of images of the standard abdominal vasculature and its variations, as an aid in emergency situations, such as gastrointestinal bleeding 11 , 13 , 16 , 18 , 20 , 21 , 23 .…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

et al. 2018

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Objective To describe the main anatomical variations of the celiac trunk and the hepatic artery at their origins.Materials and Methods This was a prospective analysis of 100 consecutive computed tomography angiography studies of the abdomen performed during a one-year period. The findings were stratified according to classification systems devised by Sureka et al. and Michels.Results The celiac trunk was "normal" (i.e., the hepatogastrosplenic trunk and superior mesenteric artery originating separately from the abdominal aorta) in 43 patients. In our sample, we identified four types of variations of the celiac trunk. Regarding the hepatic artery, a normal anatomical pattern (i.e., the proper hepatic artery being a continuation of the common hepatic artery and bifurcating into the right and left hepatic arteries) was seen in 82 patients. We observed six types of variations of the hepatic artery.Conclusion We found rates of variations of the hepatic artery that are different from those reported in the literature. Our findings underscore the need for proper knowledge and awareness of these anatomical variations, which can facilitate their recognition and inform decisions regarding the planning of surgical procedures, in order to avoid iatrogenic intraoperative injuries, which could lead to complications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

et al. 2018

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“…Radiologists play a fundamental role in their identification; with advances in the imaging techniques employed in angiography, computed tomography, and magnetic resonance, in both data acquisition but also in image postprocessing on workstations, it is possible to obtain information that facilitates the planning of a procedure which can ultimately contribute to reducing the associated rates of morbidity and mortality [31], [32], [33], [34].…”

Section: Resultsmentioning

confidence: 99%

Vascular anomalies of the celiac trunk and implications in treatment of HCC with TACE. Description of a case and review of the literature

Roma¹,

D'Amato²,

Ranalli³

et al. 2019

Radiology Case Reports

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Knowledge of the vascular anatomy of the upper abdomen is important in the daily practice of surgeons specialized in the hepatobiliary and pancreatic area, and for general surgeons and radiologists, mainly those involved in interventional radiology. Since anatomical variants of the celiac axis and hepatic arteries are common, an accurate description of vascularization is required before procedures to avoid iatrogenic vascular changes. We reported a case of a young male patient with HBV related cirrhosis, who came to our institution for the treatment of 2 HCC nodules. The preprocedural contrast-enhanced CT examination showed combined variations of celiac trunk, hepatic arteries, gastroduodenal artery, and right inferior phrenic artery. The careful pre- and intraprocedural evaluation of vascularization allowed us to perform transarterial chemoembolization of the 2 nodules without complications. The incidence and developmental and clinical significance of this variation is discussed with a detailed review of the literature. Knowledge of such a case has important clinical significance in abdominal operations or invasive arterial procedures.

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“…The portal vein forms posteriorly to the neck of the pancreas, at the junction of the splenic and superior mesenteric veins ( 7 , 8 ) . In the hepatic hilum, it divides into right and left branches, which insert into the liver, projecting a portal branch into the center of each hepatic segment ( Figure 1 ).…”

Section: Anatomy Of the Portal Venous Systemmentioning

confidence: 99%

The ABCD of portal vein thrombosis: a systematic approach

et al. 2020

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Portal vein thrombosis refers to complete or partial obstruction of the portal venous system, in the intrahepatic or extrahepatic venous tract or even in the splenic or superior mesenteric veins. This common and potentially fatal condition can develop in various clinical contexts, especially those of liver cirrhosis, hepatocellular carcinoma, and other solid tumors. Certain characteristics, such as the time since the onset of the thrombus (acute or chronic), its biology (hematic or tumoral), the presence of collateral vessels, and the magnetic resonance imaging aspects, are important components of a thorough, careful analysis, as well as informing decisions regarding the appropriate therapeutic strategy. Here, we present a brief review of the anatomy of the portal venous system and a systematic approach to analyzing the condition, using a mnemonic (ABCD, for age, biology, collaterals, and diffusion). We discuss the various imaging methods and illustrate our discussion with images selected from the case files archived at our facility.

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Acquired portosystemic collaterals: anatomy and imaging

Cited by 9 publications

References 15 publications

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

Vascular anomalies of the celiac trunk and implications in treatment of HCC with TACE. Description of a case and review of the literature

The ABCD of portal vein thrombosis: a systematic approach

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