Collateral channels and histopathology in hepatic vein occlusion

Hepatic arteriography, venography, and histopathology were reviewed in 20 patients with hepatic venous occlusion. The hepatic histologic materials (14 patients) were carefully examined in retrospect and correlated with the angiographic findings. Hepatic arteriographic findings were usually nonspecific but revealed neoplasms in all six patients studied and collaterals in four. Collateral channels that were recognized angiographically in 15 patients were extrahepatic, intrahepatic-interlobar, and indeterminate. The intrahepatic type was found in the partial Budd-Chiari syndrome, whereas other patterns were present in both diffuse and localized forms of hepatic venous occlusive disease. Histologically, the centrilobular sinusoids were congested and distorted in association with parenchymal destruction and compression. Hepatic venography correlated poorly with histopathologic findings.