J.Jpn. Surg. Soc.. 81(12): 1570-1575, 1980
Original article
HEMODYNAMIC STUDIES ON THE DEVELOPMENT OF ESOPHAGEAL VARICES IN THE PORTAL HYPERTENSIVE DOG
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1st Department of Surgery, Kurume University School of Medicine Hideaki Yamana, Jinryo Takeda, Teruo Kakegawa |
1) Post mortem injection studies were performed through the left gastric artery or vein in 14 dogs in which had been produced portal hypertension by an entire liver compression. The left gastric arteriograms showed marked hypervascularity in mucosa of upper gastric resion and the venograms showed marked dilatation of gastric submucosal veins with increasing veno-veno shunting.
2) The microscopic finding following an arteriography showed a hypaque filling in esophageal submucosal veins and in gastric ones of lesser curvature, and following a venography it showed a hypaque filling in gastric submucosal arteries of lesser curvature.
3) Three normal and 3 portal hypertension dogs were used for observing the development of the gastric arteriovenous shunting. 131I-M.A.A. (100 μci) was injected into the left gastric artery and measured R.I. counts of each section (stomach, esophagus, lung, liver & spleen) by means of Well type scintiration counter. In normal dogs the average of R.I. count rate in stomach was 98%. In portal hypertension dogs it was 76%, while the rest of 24% was counted in other sections.
These studies revealed the development of gastric arteriovenous shunting in the state of portal hypertension. It is our conclusion that hyperhemodynamic state in upper gastric region caused by marked development of arteriovenous shunting seemed to be one of the most important factor to form the esophageal varices.
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