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Differential diagnosis of early opacification of the portal vein and its tributaries during arteriography

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Abstract

Twenty-two cases with communication of an artery and the portal vein or one of its tributaries are discussed. Four conditions in which relatively significant arterio-portal shunts may exist can be differentiated: (1) angiodysplasias or arteriovenous malformations, (3) traumatic and postoperative lesions, and (4) benign and malignant tumors. The significance of the portal vein's early opacification during arteriographic examinations of the abdominal organs is discussed, and the findings are compared to those reported in the literature.

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References

  1. Abrams, H.L.: Angiography. Boston: Little, Brown and Company, 1974, p. 1109

    Google Scholar 

  2. Alfidi, R.J., Esselstyn, C.D., Tarar, R., Ulein, H.J., Herman, R.E., Weakley, F.L., Turnbull, R.B.: Recognition and angiosurgical detection of arterio-venous malformation of the bowel. Ann. Surg. 174:573–581, 1971

    Article  PubMed  CAS  Google Scholar 

  3. Bear, J.W., Ryan, S.: Analysis of cecal vasculature in the search of vascular malformations. Am. J. Roentgenol. 126:394–405, 1976

    Google Scholar 

  4. Baghery, S., Alfidi, R.J., Zeilch, M.G.: Angiography of non-functioning islet cell tumors of the pancreas. Radiology 120:57–59, 1976

    PubMed  CAS  Google Scholar 

  5. Bass, E.M.: The radiological diagnosis of hepatoma with special emphasis on angiography. S. Afr. Med. J. 49:745–751, 1975

    PubMed  CAS  Google Scholar 

  6. Baum, S., Stein, G., Nusbaum, M., Chait, A.: Selective arteriography in the diagnosis of hemorrhage in the gastrointestinal tract. Radiol. Clin. North Am. 7:131–145, 1969

    PubMed  CAS  Google Scholar 

  7. Baum, S. Athanasoulis, C.A., Waltman, A.C., Galdabini J., Schapiro, R.H., Warshaw, A.L., Ottinger, L.W.: Angiodysplasias of the right colon: A cause of gastrointestinal bleeding. Am. J. Roentgenol. 129:789–794, 1977

    CAS  Google Scholar 

  8. Besson, A., Saegesser, F.: Hemorrhagic massive recidivente de la partie distale du tube digestif par telangiectasies hemorragigues hereditaires de Rendu-Osler-Weber. Schweiz. Med. Wochenschr. 107:1057–1064, 1977

    PubMed  CAS  Google Scholar 

  9. Biersack, H.J., Bücheler, E., Hünermann, B., Schulz, D., Winkler, C.: Zirrhose-Karzinom oder Regeneration? Nuklearmedizinische und röntgenologische Methoden in der Differentialdiagnose. Roentgenbl. 28:399–406, 1975

    CAS  Google Scholar 

  10. Boijsen, E.: Inactive malignant endocrine tumors of the pancreas. Radiologe 15:177–182, 1975

    PubMed  CAS  Google Scholar 

  11. Bruusgaard, A., Juhl, E.: Hereditary hemorrhagic telangiectasis (Rendu-Weber-Osler's disease) with intestinal involvement successfully treated by surgery. Gastroenterology 67:1001–1005, 1974

    PubMed  CAS  Google Scholar 

  12. Bücheler, E., Boldt, I., Frommhold, H.: Leistungsfähigkeit und Grenzen der Leberarteriographie. Fortschr. Geb. Roentgenstr. Nuklearmed. 119:530, 1973

    Google Scholar 

  13. Buurman, R., Bücheler, E., Boldt, I.: Das Leberhämangiom im Angiogramm. Fortschr. Geb. Roentgenstr. Nuklearmed. 123:393–399, 1975

    Article  CAS  Google Scholar 

  14. Cavett, C.M., Selby, J.H., Hamilton, J.L., Williamson, J.W.: Arterio-venous malformation in chronic gastrointestinal bleeding. Ann. Surg. 185:116–121, 1977

    Article  PubMed  CAS  Google Scholar 

  15. Cleveland, R.J., Jackson, B.M., Newman, P.H. et al.: Traumatic intrahepatic artery-portal vein fistula with associated hemobilia. Ann. Surg. 171:451–454, 1970

    Article  PubMed  CAS  Google Scholar 

  16. Cody, M.C., O'Donovan, P.B., Hughes, R.W.: Idiopathic gastrointestinal bleeding and aortic stenosis. Am. J. Dig. Dis. 19:393–398, 1974

    Article  PubMed  CAS  Google Scholar 

  17. Cooperman, A.M., Kelly, K.A., Bernatz, P.E., Huizenga, K.A.: Arterio-venous malformation of the intestine: An uncommon cause of gastrointestinal bleeding. Arch. Surg. 104:284–287, 1972

    PubMed  CAS  Google Scholar 

  18. Crichlow, R.W., Mosenthal, W.T., Spiegel, P.K., House, R.K. Arterio-venous malformations of the bowel. Am. J. Surg. 129:440–448, 1975

    Article  PubMed  CAS  Google Scholar 

  19. Farrell, R., Steinmann, A., Green, W.H.: Arterio-venous shunting in a regenerating liver simulating hepatoma. Radiology 102:279–280, 1972

    PubMed  CAS  Google Scholar 

  20. Foley, W.J., Turcotte, J.G., Hoskins, P.A., Brant, R.L., Ause, R.G.: Intrahepatic arterio-venous fistulas between the hepatic artery and portal vein. Ann. Surg. 174:849–855, 1971

    Article  PubMed  CAS  Google Scholar 

  21. Fulton, R.L., Wolfel, D.A.: Hepatic arterio-portal vein fistula. Arch. Surg. 100:307–309, 1970

    PubMed  CAS  Google Scholar 

  22. Gronmark, T., Dingsor-Nilsen, G., Solheim, K.: Porto-systemicarterio-venous fistula. Acta Chir Scand 141:442–444, 1975

    PubMed  CAS  Google Scholar 

  23. Halpern, M., Turner, A.F., Citron, B.P.: An angiographic study of abdominal visceral angiodysplasias associated with gastrointestinal hemorrhage. Radiology 90:1143–1149, 1968

    PubMed  CAS  Google Scholar 

  24. Hunt, T.K., Leeds, F.H., Wanebo, H.J.: Arterio-venous fistulas of major vessels in the abdomen. J Trauma 11:483, 1971

    Article  PubMed  CAS  Google Scholar 

  25. Itzchak, Y., Adar, R., Bogokowski, H., Mozes, M., Deutsch, V.: Intrahepatic arterial-portal communications: Angiographic study. Am. J. Roentgenol. Radium Ther. Nucl. Med. 121: 384–387, 1974

    PubMed  CAS  Google Scholar 

  26. Kido, C., Sasaki, T., Kaneko, M.: Angiography of primary liver cancer. Am. J. Roentgenol. Radium Ther. Nucl. Med. 113:70–81, 1971

    PubMed  CAS  Google Scholar 

  27. Kinkhabwala, M.N., Becker, J.A., Rabinowitz, J.G.: Osler-Weber-Rendu syndrome with multiple angiographic findings. Br. J. Radiol. 45:534–536, 1972

    Article  PubMed  CAS  Google Scholar 

  28. Korobkin, M., Kantor, I., Pollard, J.J., Nebesar, R.A., Athanasoulis, C.A., Wack, J., Palubinskas, A.J.: Arterio-venous fistula between systemic and portal circulations following partial gastrectomy. Radiology 109:311–314, 1973

    PubMed  CAS  Google Scholar 

  29. Levin, D.C., Watson, R.C., Sos, T.A., Baltaxe, H.A.: Angiography in blunt hepatic trauma. Am. J. Roentgenol. Radium Ther. Nucl. Med. 119:95–100, 1973

    PubMed  CAS  Google Scholar 

  30. Metges, P.J., Delahaye, R.P., Lomazzir, Essioux, H., Thabaut, A., Chantome, M.: Nésidioblastome malin non fonctionel. J Radiol. Electrol. 57:527–532, 1976

    PubMed  CAS  Google Scholar 

  31. Moore, J.D., Norman, W.T., Appelman, H.D., Dennis, F.: Arterio-venous malformations of the gastrointestinal tract Arch. Surg. 111:381–388, 1976

    PubMed  CAS  Google Scholar 

  32. Nahum, H., Levesque, M.: Arteriography in hepatic trauma Radiology 109:557–563, 1973

    PubMed  CAS  Google Scholar 

  33. Neiman, H.L., Goldstein, H.M.: Angiography of benign and malignant hepatic masses. Semin. Roentgenol. 10:197–205, 1975

    Article  PubMed  CAS  Google Scholar 

  34. Okuda, K., Moriyama, M., Yasumoto, M. et al.: Roentgenologic demonstration of spontaneous reversal of portal blood flow in cirrhosis and primary carcinoma of the liver. Am. J. Roentgenol. Radium Ther. Nucl. Med. 119:422–425, 1974

    Google Scholar 

  35. Okuda, K., Musha, H., Yoshida, T. et al.: Demonstration of growing casts of hepatocellular carcinoma in the portal vein by celiac angiography: The thread and streaks sign. Radiology 117:303–309, 1975

    PubMed  CAS  Google Scholar 

  36. Okuda, K., Musha, H., Yamasaki T. Jinnouchi, S., Nagasaki, Y., Kubo, Y. et al.: Angiographic demonstration of intrahepatic arterio-portal anastomoses in hepato-cellular carcinoma. Radiology 122:53–58, 1977

    PubMed  CAS  Google Scholar 

  37. Okuda, K., Obata, H., Jinnouchi, S., Kubo, Y., Nagasaki, Y., Shimokawa, Y. et al.: Angiographic assessment of gross anatomy of hepatocellular carcinoma: Comparison of celiac angiograms and liver pathology in 100 cases. Radiology 123:21–29, 1977

    PubMed  CAS  Google Scholar 

  38. Perlman, H.C., Weiland, P.O.: An unusual case of arterio-venous fistula diagnosed by arteriography during pregnancy. Angiology 24:212–215, 1973

    PubMed  CAS  Google Scholar 

  39. Quintiliani, R., Ganguli, P.: Splenic arterio-venous fistula with bacterial endarteritis and endocarditis. JAMA 214:727–730, 1970

    Article  PubMed  CAS  Google Scholar 

  40. Rabinowitz, J.G., Konkabwala, M., Ulreich, S.: Macroregenerating nodule in the cirrhotic liver: Radiologic features and differential diagnosis. Am. J. Roentgenol. Radium Ther. Nucl. Med. 121:401–411, 1974

    PubMed  CAS  Google Scholar 

  41. Razi, B., Beller, B.M., Ghidoni, J., Linhart, J.W., Talley, R.C., Urban, E.: Hyperdynamic circulatory state due to intrahepatic fistula in Osler-Weber-Rendu disease. Am. J. Med. 50:809–815, 1971

    Article  PubMed  CAS  Google Scholar 

  42. Reuter, S.R., Redman, H.C.: Gastrointestinal Angiography. Philadelphia: W. B. Sauders Company, 1972, p. 14

    Google Scholar 

  43. Satava, R.M., Van Heerden, J.A., Sheedy, P.F., Summerskill, W.H.J.: Omental arterio-venous fistula following liver biopsy. Gastroenterology 69:492–495, 1975

    PubMed  Google Scholar 

  44. Shultz, E.H., Anderson, W.B., Rösch, J.: Traumatic intrahepatic arterio-portal fistula. Br. J. Radiol. 43:727–731, 1970

    Article  Google Scholar 

  45. Showalter, B., Johnston, D.O., Wise, R.E.: Arterio-venous malformation of the intestine diagnosed by arteriography. Lahey Clin. Bull. 19:22–27, 1970

    CAS  Google Scholar 

  46. Steinberg, I., Tillotan, P.M., Halpern, M.: Roentgenography of systemic (congenital and traumatic) arterio-venous fistulas. Am. J. Roentgenol. Radium Ther. Nucl. Med. 89:343, 1963

    PubMed  CAS  Google Scholar 

  47. Stoppa, R., Pietri, J., Capron, J.P., Monchaux, G., Duclaye, C., Henry, X.: Les fistules arterio-veineuses portosystemique. Ann. Chir. 27:227, 1973

    PubMed  CAS  Google Scholar 

  48. Tanenbaum, B., Prochaczevsky, R., Levowitz, B.S., Richter, R.M.: Traumatic mesenteric arterio-venous fistula. Br. J. Radiol. 43:726–729, 1970

    PubMed  CAS  Google Scholar 

  49. Thomas, L., Carty, H.: Hereditary hemorrhagic telangiectasia of the liver demonstrated angiographically. Acta radiol. [Diagn] (Stockh.) 15:433–438, 1974

    CAS  Google Scholar 

  50. Trinez, D., Grumbach, Y., Rémond, A., Descombes, Ph., Piétri, J., Capron, J.P., Braibant, J.M.: Intérêt de l'artériographie sélective dans le diagnostic étiologique des hémorragies digestives inexpliquées. J. Radiol. Electrol. 55:111–116, 1974

    PubMed  CAS  Google Scholar 

  51. Van Way, C.W., Crane, J.M., Riddell, D.H., Foster, J.H.: Arterio-venous fistula in the portal circulation. Surgery 70:876–889, 1971

    PubMed  Google Scholar 

  52. Viamonte, M., Martinez, L.O., Parks, L.E.: Liver shunts. Am. J. Roentgenol. Radium Ther. Nucl. Med. 102:773–775, 1968

    PubMed  Google Scholar 

  53. Viamonte, M., Warren, W.D., Fomon, J.J.: Liver panangiography in the assessment of portal hypertension in liver cirrhosis. Radiol. Clin. North Am. 8:147–167, 1970

    PubMed  Google Scholar 

  54. Viamonte, M., LePage, J.R., Russell, E., Roen, S.A., Pereiras, R., Zeppa, R., Viamonte, M.: The hemodynamics of diffuse liver disease. Semin. Roentgenol. 10:187–196, 1975

    Article  PubMed  Google Scholar 

  55. Wallace, S., Medellin, H., Nelson, R.S.: Angiographic changes due to needle biopsy of the liver. Radiology 105:13–18, 1972

    PubMed  CAS  Google Scholar 

  56. Warren, W.D., Fomon, J.J., Viamonte, M., Martinez, L.D., Kaiser, M.: Spontaneous reversal of portal venous blood flow in cirrhosis. Surg. Gynec. Obstet. 126:315–323, 1968

    Google Scholar 

  57. Winograd, J., Palubinskas, A.J.: Arterial-portal shunting in cavernous hemangioma of the liver. Radiology 122:331–332, 1977

    PubMed  CAS  Google Scholar 

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Sörensen, R., Holtz, U., Banzer, D. et al. Differential diagnosis of early opacification of the portal vein and its tributaries during arteriography. Cardiovasc Radiol 1, 179–185 (1978). https://doi.org/10.1007/BF02552030

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