[Hepatoportal circulatory modifications after splenorenal anastomosis (author's transl)]

An angiographic study was performed in five patients following splenorenal anastomosis with splenectomy, to evaluate hepatoportal circulatory modifications after surgery. All cases had angiographic investigations by arterioportography. In one case catheterization of the anastomosis was also associated and in another case hepatic phlebography. Hepatopetal blood flow was observed in only two patients examined within 6 days of the operation. In one of these cases a second angiographic examination was made 10 days later and demonstrated that hepatopetal portal flow had disappeared. In the other patients, examined after one month, one year, and five years respectively, the mesenteric blood flow was completely deviated through the anastomosis towards the inferior vena cava, without any opacification in the portal vein. In three patients, selective hepatic arteriography showed inversed portal flow. All late investigations demonstrated a great increase of hepatic artery size and of the intrahepatic arterial branches.