By Scott J. Savader, Scott O. Trerotola
""The world's such a lot authoritative paintings relating to venous intervention.""--_x000D_Gary J. Becker, MD (from the foreword)_x000D__x000D_In the 3 years considering that ebook of the ...
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The portal vein is occluded. Multiple serpiginous collaterals are seen, consistent with the diagnosis of cavernous transformation of the portal vein. A neoplastic occlusion of the portal vein is a presinusoidal cause of portal hypertension. Renal nephrograms are identified and are caused by reflux of contrast into the aorta during the selective superior mesenteric arteriogram. On the arterial and venous phases, vascular encasement was confirmed. 11 Causes of intrahepatic presinusoidal portal hypertension include (1) infection or inflammation, (2) congenital disorders, (3) infiltration, and (4) miscellaneous.
A platelet count of 600,000 to 2,000,000/μL may be seen after surgery, with greater than one-third of patients demonstrating platelet count elevation up to 7 years after surgery. 94 CHAPTER 2 Angiographic, Venographic, and Hemodynamic Evaluation of Portal Hypertension 19 Hepatic venography will demonstrate obliteration of the normal hepatic vein(s). The distribution of hepatic vein thrombosis can be segmental or global. The recanalized and collaterized hepatic veins have a complex spiderweb appearance, which is classical (Fig.
FIGURE 2–14. The portal venous phase of the superior mesenteric artery arteriogram demonstrates hepatofugal flow in an enlarged umbilical and periumbilical vein (arrows). FIGURE 2–15. Portal venous phase of the superior mesenteric artery arteriogram demonstrates direct shunting from the portal vein (tailed arrow) to the inferior vena cava (open arrow). 18 SECTION 1 Portal Hypertension a b c FIGURE 2–16. (a) Early parenchymal phase film following direct hepatic artery injection demon-strates faint opacification of the portal vein (arrow).