title: Cruveilhier-Baumgarten syndrome: an efficient spontaneous portosystemic collateral preventing oesophageal varices bleeding.
abstract: The protective role of large spontaneous portosystemic shunts in oesophageal varices bleeding due to portal hypertension in liver cirrhosis is still debated. A series of 20 consecutive patients with haemodynamically efficient collaterals involving the para-umbilical-epigastric venous route (evaluated by Echo-Doppler flowmetry) is reported. All patients presented absent or mild oesophageal varices at endoscopy. During a mean follow-up period of 23.5 months, no patient developed large varices or experienced variceal bleeding. Hepatic encephalopathy was present in 35% of patients. Haemodynamically efficient spontaneous portosystemic shunts may protect cirrhotic patients from the risk of oesophageal varices forming and bleeding. The diversion of large amounts of blood from portal to systemic circulation correlates with the higher trend of hepatic encephalopathy in these patients.
authors.affiliation: Divisione di Gastroenterologia, Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Foggia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Caturelli
authors.forename: M
authors.initials: M
authors.lastname: Pompili
authors.forename: M M
authors.initials: MM
authors.lastname: Squillante
authors.forename: G
authors.initials: G
authors.lastname: Sperandeo
authors.forename: S
authors.initials: S
authors.lastname: Carughi
authors.forename: M
authors.initials: M
authors.lastname: Sperandeo
authors.forename: F
authors.initials: F
authors.lastname: Perri
authors.forename: A
authors.initials: A
authors.lastname: Andriulli
authors.forename: C
authors.initials: C
authors.lastname: Cellerino
authors.forename: G L
authors.initials: GL
authors.lastname: Rapaccini
mesh_terms: D000328:Adult; D000368:Aged; D003097:Collateral Circulation; D004932:Esophageal and Gastric Varices / Q000517:prevention & control*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D014463:Ultrasonography; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000503:physiopathology