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J Clin Exp Hepatol. 2012 Dec;2(4):338-52. doi: 10.1016/j.jceh.2012.08.001. Epub 2012 Dec 16.

Collateral pathways in portal hypertension.

Author information

1
Jaswant Rai Speciality Hospital, Saket, Meerut 250 001, Uttar Pradesh, India.
2
Dept. of Anatomy, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India.

Abstract

Presence of portosystemic collateral veins (PSCV) is common in portal hypertension due to cirrhosis. Physiologically, normal portosystemic anastomoses exist which exhibit hepatofugal flow. With the development of portal hypertension, transmission of backpressure leads to increased flow in these patent normal portosystemic anastomoses. In extrahepatic portal vein obstruction collateral circulation develops in a hepatopetal direction and portoportal pathways are frequently found. The objective of this review is to illustrate the various PSCV and portoportal collateral vein pathways pertinent to portal hypertension in liver cirrhosis and EHPVO.

KEYWORDS:

AIPDV, anterior inferior pancreatico duodenal vein; ASPDV, anterior superior pancreatico duodenal vein; AV, azygos vein; BCS, Budd–Chiari syndrome; CBD, common bile duct; CT, computed tomography; DV, duodenal varices; ECD, epicholedochal; EHPVO, extrahepatic portal vein obstruction; ERVP, extrinsic rectal venous plexus; FJT, first jejunal trunk; GEV, gastroepiploeic vein; GT, gastrocolic trunk; GV, gastric varices; IMV, inferior mesenteric vein; IPDV, inferior pancreatico duodenal vein; IRV, inferior rectal veins; IRVP, intrinsic rectal venous plexus; IVC, inferior vena cava; LGEV, left gastroepiploic vein; LGV, left gastric vein; LPV, left portal vein; MCV, middle colic vein; PACD, paracholedochal; PHB, portal hypertensive biliopathy; PIPDV, posterior inferior pancreatico duodenal vein; PPCV, portoportal collateral vein; PSCV, portosystemic collateral veins; PSPDV, posterior superior pancreatico duodenal vein; PUV, paraumbilical vein; PV, portal vein; PVT, portal vein thrombosis; RGEV, right gastroepiploic; RGV, right gastric vein; SMV, superior mesenteric vein; SRV, superior rectal vein; SV, splenic vein; SVC, superior vena cava; US, ultrasonography; collateral pathways; portal hypertension; varices

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