Yashiro N, Kokubo T, Iio M, Takekawa S
Radiat Med. 1984 Jan-Mar;2(1):44-8.
Eight Japanese patients with mesenteric varices were diagnosed by angiography. All patients suffered from portal hypertension and had a history of previous abdominal surgery or peritonitis. The mesenteric varices of these patients were thought to be related to adhesion. Of the eight patients, five showed hepatic encephalopathy. None of the patients had a history of massive lower-gastrointestinal bleeding. All mesenteric varices were opacified in the portal phase of superior mesenteric arteriograms. To study the superior mesenteric artery, 50-60 ml of 76% Urografin was injected after infusion of prostaglandin E1 or F2 alpha. Regarding patients treated in the early part of the study, a vasodilator was not used and the contrast dosage was modest. In all eight patients, the mesenteric varices communicated with the systemic venous circulation through the gonadal veins. In seven cases, the mesenteric varices on the right side of the mesenteries drained into the right gonadal veins which flowed into the inferior vena cava (IVC). In the remaining case, the mesenteric varix on the left side drained into the left gonadal vein which flowed into the left renal vein. In three patients with right-sided varices, venous blood sampled from the right gonadal vein and from the distal and proximal IVC showed a high concentration of ammonia in the right gonadal vein and step-ups between distal and proximal IVC.
八名患有肠系膜静脉曲张的日本患者通过血管造影术得以确诊。所有患者均患有门静脉高压症，且有腹部手术史或腹膜炎病史。这些患者的肠系膜静脉曲张被认为与粘连有关。八名患者中有五名出现肝性脑病。所有患者均无大量下消化道出血史。在肠系膜上动脉造影的门静脉期，所有肠系膜静脉曲张均显影。为研究肠系膜上动脉，在输注前列腺素E1或F2α后注入50 - 60毫升76%的泛影葡胺。对于在研究早期接受治疗的患者，未使用血管扩张剂，造影剂用量适中。在所有八名患者中，肠系膜静脉曲张通过性腺静脉与体循环静脉相通。七例中，肠系膜右侧的静脉曲张汇入右侧性腺静脉，后者流入下腔静脉。在其余一例中，左侧的肠系膜静脉曲张汇入左侧性腺静脉，后者流入左肾静脉。在三名右侧静脉曲张患者中，从右侧性腺静脉以及下腔静脉远心端和近心端采集的静脉血显示，右侧性腺静脉中氨浓度较高，且下腔静脉远心端和近心端之间存在梯度升高。
