Percutaneous transhepatic portography. II. Comparison with splenoportography in portal hypertension

A Large Spontaneous Splenorenal Shunt in a Patient with Liver Cirrhosis and Uncomplicated Portal Hypertension

“…An enlarged commun-(including increased sensitivity, earlier visualization of the portal venous system, lower contrast loads, and lack icating vein between portal and left renal veins was found which seemed to be formed by the union of the left gastric of need for vasodilators) [55], or transhepatic portography (by percutaneous transhepatic portal catheterization) vein and the cardioesophageal branch of the left inferior phrenic vein which opened into the left renal vein [65]. [56][57][58]. Transhepatic portography in patients with Specific treatments (portocaval shunt or splenectomy) several complications, as reported in the literature [10,14,24,27].…”

“…Percutaneous tosystemic shunts). Noninvasive, nonexpensive, harmless, and rapid techniques are ultrasonography [8,[44][45][46], real-transhepatic portography, improved by ultrasonically guided puncture, may be performed with little risk and time/pulsed Doppler ultrasonography (capable of determining the direction and rate of blood flow in large veins) is proved to be superior with regard to delineation of the portal venous system and esophageal varices [56,57]. In [17,47], color Doppler sonography, and duplex Doppler ultrasonography [21,[48][49][50].…”

“…In [17,47], color Doppler sonography, and duplex Doppler ultrasonography [21,[48][49][50]. Part of the course of the several studies, this procedure was reported to be successful in 96% of the examinations, visualizing collateral veins portocaval anastomotic vessels can be visualized by ultrasonography opposite the left adrenal gland and in the in 81% and varices in 69% of the patients with portal hypertension [56,57]. Arterioportography may be also space between the spleen and the left kidney.…”

Complications of gastrointestinal radiologic procedures: III. Complications of diagnostic and interventional angiography

“…Such studies are therefore contraindicated in patients with a hemorrhagic diathesis or ascites, in which case the tamponade effect of the abdominal wall may be diminished. Significant poststudy hemorrhage is variously reported as 2% 3% with splenoportography [57 59] and 0-1% with transhepatic portography [57,60,61]. Placement of a small plug of occluding material, e.g., gelatin sponge, at the periphery of the hepatic needle track greatly reduces the frequency of this complication in transhepatic portography [56].…”

Safe splenoportography: Objective confirmation is still needed

“…The prevalence of HHs varies in the literature: from 0% by Conn (1) (using "Tc) and Buscarini et al (2) (ultrasound scan); 7% by Raines et al (3), and 8% by Hellekant (4) using "Tc and arteriography, respectively, and 23% in the study under discussion.…”