Patterns of collateral pathways in extrahepatic portal hypertension as demonstrated by multidetector row computed tomography and advanced image processing.
Pancreatic neoplasm can compromise the portal vein or its tributaries, resulting in extrahepatic portal hypertension. Collateral channels may develop, usually in a hepatopetal direction. These include gastroepiploic veins, short gastric veins, left gastric vein, left colic veins, and spontaneous splenorenal shunts. We present the spectrum of these collaterals as delineated by multidetector row computed tomography with advanced image processing. Delineation of these collaterals is important before surgery so as to avoid possible uncontrollable bleeding if they are inadvertently disrupted.
Kamel
Ihab R
IR
Russel H Morgan Department of Radiology, Johns Hopkins Hospital, Baltimore, MD 21287, USA. ikamel@hjmi.edu
Lawler
Leo P
LP
Corl
Frank M
FM
Fishman
Elliot K
EK
D000368:Aged; D003097:Collateral Circulation / Q000502:physiology*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000503:physiopathology; D008642:Mesenteric Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D011168:Portal System / Q000503:physiopathology; D011169:Portal Vein / Q000503:physiopathology; D011172:Portography; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods*