Journal of Ultrasound in Medicine, Vol 4, Issue 6 297-305, Copyright © 1985 by American Institute of Ultrasound in Medicine
Ultrasound detection of unusual spontaneous portosystemic shunts associated with uncomplicated portal hypertension
G. Di Candio, A. Campatelli, F. Mosca, V. Santi, P. Casanova and L. Bolondi
Seven cases of unusual spontaneous portosystemic shunts observed by
ultrasonography in the last 8 months are reported, including cases of
coronary vein varicocele and patent umbilical vein; two cases of
spleno-retroperitoneal anastomosis; omphalo-ilio-caval anastomosis;
superior mesenteric vein-inferior vena cava anastomosis; spleno-renal
anastomosis; and spleno-portal anastomosis and anastomosis from the splenic
vein to the abdominal wall. One of these collateral vessels was also
analyzed by pulsed Doppler flowmetry. The patients were either cirrhotic or
had pre-hepatic portal hypertension (resulting from chronic pancreatitis)
and gave no history of gastrointestinal bleeding or ascites. Two of these
patients had previously undergone surgery for problems associated with
cholestasis. In both cases, presurgical sonographic studies were used to
guide the surgical procedures in the hope of preserving the anomalous
connections. Furthermore, ultrasound detection of spontaneous portosystemic
shunts was an important factor in interpreting the clinical symptoms of
these patients.
