Budd-Chiari syndrome: Diagnosis with three-dimensional contrast-enhanced magnetic resonance angiography

Lin, Jia Wei; Chen, Xiao-Hai; Zhou, Kaihua; Zuwang, Chen; Wang, Jianhua; Yan, Zhenlin; Wang, Ping

doi:10.3748/wjg.v9.i10.2317

Cited by 25 publications

(18 citation statements)

References 30 publications

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“…The inferior epigastric vein runs within the lateral umbilical peritoneal fold, and then passes to the posterior surface of the musculus rectus abdominis. 98,99 …”

Section: Abdominal Wallmentioning

confidence: 99%

Collateral Pathways in Portal Hypertension

Sharma

Rameshbabu²

2012

Journal of Clinical and Experimental Hepatology

128

104

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Presence of portosystemic collateral veins (PSCV) is common in portal hypertension due to cirrhosis. Physiologically, normal portosystemic anastomoses exist which exhibit hepatofugal flow. With the development of portal hypertension, transmission of backpressure leads to increased flow in these patent normal portosystemic anastomoses. In extrahepatic portal vein obstruction collateral circulation develops in a hepatopetal direction and portoportal pathways are frequently found. The objective of this review is to illustrate the various PSCV and portoportal collateral vein pathways pertinent to portal hypertension in liver cirrhosis and EHPVO. ( J CLIN EXP HEPATOL 2012;2:338-352) A lmost any vein in the abdomen may serve as a potential collateral channel to the systemic circulation. Presence of abnormal collateral vessels appears to be one of the most sensitive (70-83%) and specific sonographic signs for the diagnosis of portal hypertension. 1 When blood flow through a vessel or a vascular bed is obstructed due to occlusion, as in EHPVO, or distortion, as in liver cirrhosis, collateral pathways open up as blood bypasses the occlusion or obstruction, always flowing down a pressure gradient from a high pressure to a low-pressure vessel or bed. The formation of portosystemic pathways occurs due to reopening of collapsed embryonic channels or reversal of the flow within existing adult veins. 2,3 The number of collateral channels depends on the severity of portal hypertension i.e. the differential gradient driving the flow between the portal and the systemic circulations and the duration of portal hypertension. The more severe and more prolonged the portal hypertension, the higher are the number of portosystemic pathways. However, this traditional hypothesis has been challenged and it has been suggested that the formation of portosystemic collateral circulation may be due in part to angiogenesis driven by vascular endothelial growth factor. 4,5 Almost 50 years have passed since the first detailed description of portosystemic collateral veins (PSCV) in portal hypertension appeared. 6 Precise mapping of PSCV is essential to therapeutic decisions and multidetector computerized tomography (MDCT) is sometimes used for cartography of PSCV. 7 EUS is increasingly being used for evaluation of PSCV and additionally provides an option for performing therapeutic interventions. 8 In addition to PSCV, PPCV pathways are frequently found in extrahepatic portal vein obstruction (EHPVO). The objective of this review is to illustrate the various PSCV and PPCV pathways pertinent to portal hypertension in liver cirrhosis and EHPVO. NORMAL PORTOSYSTEMIC ANASTOMOSESThe left gastric vein (LGV) anastomoses with the esophageal veins, which in turn drain into the azygos vein (AV). The superior rectal vein (SRV) anastomoses with the middle and inferior rectal veins (IRV), which are, respectively, tributaries of the internal iliac and the pudendal veins. The paraumbilical vein (PUV) anastomoses with subcutaneous veins in the anterior abdominal...

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“…The inferior epigastric vein runs within the lateral umbilical peritoneal fold, and then passes to the posterior surface of the musculus rectus abdominis. 98,99 …”

Section: Abdominal Wallmentioning

confidence: 99%

Collateral Pathways in Portal Hypertension

Sharma

Rameshbabu²

2012

Journal of Clinical and Experimental Hepatology

128

104

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“…Reported variations in the branching pattern of the celiac trunk include absence of the trunk (Vandamme & Bonte, 1985), presence of collateral vessels (Cavdar et al, 1998) and anomalous branches (Cavdar et al, 1997;Nonent et al, 2001;Loukas & Jordan, 2006;Katagiri et al, 2007) and even bifurcation of the trunk (Ucerler & Asli, 2006). Such variations in the pattern of branching of the celiac trunk may predispose to iatrogenic injury during surgical procedures such as total pancreatomy (Vandamme & Bonte, 1990;Gielecki et al, 2005) and resection of tumors of head of pancreas (Lin, 2005). Knowledge of this variable anatomy may be useful in planning and executing radiological interventions such as celiacography (Glück et al, 1983) and chemoembolisation of hepatic tumors (Aigner & Gailhofer, 2005).…”

Section: Introductionmentioning

confidence: 99%

Variations in the Branching Pattern of the Celiac Trunk in a Kenyan Population

et al. 2010

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SUMMARY:The celiac trunk is the major source of blood supply to the supracolic abdominal compartment. Usually, it branches into the splenic, common hepatic and left gastric arteries to supply this region. It has however been shown to display ethnic variations in its branching pattern. Knowledge of these variations may be important in surgical and radiological procedures around the head of the pancreas. The aim was to illustrate the commonest variations in the branching pattern of the celiac trunk in a Kenyan population. The study was conducted in the Department of Human Anatomy, University of Nairobi. Were collected one hundred twenty three (123) bodies obtained from dissection cadavers and autopsy cases following ethical approval and consent from next of kin. Gross dissection of the anterior abdominal wall using an extended midline incision and retraction of the liver and stomach was performed. The celiac trunk was trifurcated in 76 (61.7%), bifurcated in 22 (17.9%) and gave collaterals in 25 (20.3%). Dorsal pancreatic artery was the most common collateral and occurred in 14.8%. Other branches included gastroduodenal and inferior phrenic arteries present in 3.3% and 4.9% respectively. The Kenyan population has a higher incidence of bifurcation and collateral branching of the celiac trunk hence need for caution during surgical procedures of the supracolic abdominal compartment.

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“…In embryonic development, abdominal visceral arteries develop from the primitive dorsal abdominal aorta through four roots: the left gastric artery, the hepatic artery, the splenic artery, and the SMA [12]. These roots are joined together by a ventral longitudinal anastomosis, called Lang's anastomose.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, the origins of the celiac trunk and SMA from the abdominal aorta are separated. The persistence of the ventral longitudinal anastomosis accounts for the CMT [12].…”

Section: Discussionmentioning

confidence: 99%

Celiomesenteric trunk demonstrated by multi-detector computed tomography angiography: two cases of a rare vascular variation

Rountas

Fanariotis²,

Vlychou³

et al. 2013

Folia Morphol

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We present two cases of patients with celiomesenteric trunk in whom theKey words: celiomesenteric trunk, multidetector computed tomography angiography, mesenteric arterial variation nal aorta and its branches. Multi-detector computed tomography angiography (MDCTA) is a relatively new, fast and easy to perform imaging modality which can accurately demonstrate the abdominal aorta and its branches by replacing the use of DSA [4].We describe two cases of common CMT demonstrated by MDCTA and confirmed by DSA.

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Budd-Chiari syndrome: Diagnosis with three-dimensional contrast-enhanced magnetic resonance angiography

Cited by 25 publications

References 30 publications

Collateral Pathways in Portal Hypertension

Collateral Pathways in Portal Hypertension

Variations in the Branching Pattern of the Celiac Trunk in a Kenyan Population

Celiomesenteric trunk demonstrated by multi-detector computed tomography angiography: two cases of a rare vascular variation

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