Porto-pulmonary venous anastomosis in portal hypertension demonstrated by percutaneous transhepatic cine-portography.

Analysis of portal collaterals by percutaneous transhepatic portography combined with cine-fluorography disclosed porto-pulmonary venous anastomosis in four out of 22 patients with portal hypertension. The characteristic radiological features were a sudden spurt of contrast medium from a venous collateral located near the hilus of the left lung and counterclockwise movement of the flux of contrast medium, which was rapidly diluted; this was synchronized with the cardiac beat. The clinical significance of the porto-pulmonary anastomosis as a potential channel for the migration of embolizing materials used in the obliteration of varices is discussed.