Portal stenosis

Fig. 28.12 Alcoholic cirrhosis with portal hypertension stenosis of the portal vein (see arrow) with stagnation of blood flow in the portal vein (VP) and portal flow reversal (blue = hepatofugal) as well as enhanced arterial flow (red). Arterial signals are visible in the flow profile. Inhomogeneous liver structure...

Acquired causes may also be responsible for some of the congenital anomalies described above. Mention should be made of (1.) arterioportal fistulas, (2.) cavernous transformation of the portal vein (in portal vein thrombosis), (3.) fibrous obliteration of the portal vein, and (4.) cicatricial portal vein stenosis. These may also cause prehepatic hypertension, (s. tab. 14.2) (s. p. 246 )... 

Trials of the effects of endothelin receptor antagonists in patients with heart failure, coronary artery disease, arterial hjtpertension, and pulmonary hjtpertension have been reviewed (6), as have their uses in treating cancers (7) and cerebral vasospasm (8), and their potential uses in atherosclerosis, re-stenosis, myocarditis, shock, and portal hypertension (9)... 

Partial duodenal obstruction may be produced by duodenal stenosis, duodenal web, Ladd s bands, midgut volvulus, annular pancreas, preduodenal portal vein, and duplication cyst. Plain radiographs show gaseous distension of the stomach and duodenum with a normal or diminished quantity of air in the small bowel. Content studies may be necessary to differentiate between midgut volvulus and partial duodenal obstruction caused by a web or stenosis (Auringer and Sumner 1994). Sonography is helpful to rule out extraluminal causes such as a duplication cyst. 

Angiography does not depict hilar CCA directly but can show stenosis or occlusion of the hilar or intrahepatic portions of the portal vein or hepatic artery. Nowadays, venous invasion can be accurately demonstrated by contrast-enhanced multiphasic CT or dynamic MR imaging, but angiography still remains the gold standard technique to exclude arterial involvement. 

Chronic cellular rejection Vascular complications Hepatic artery thrombosis Portal vein thrombosis Stenosis... 

Portal vein complications include thrombosis and stenosis, which have a l%-2% incidence (Langnas et al. 1991) (Fig. 4.2.20). 

Portal vein stenosis presents with signs and symptoms of portal hypertension. US shows focal color aliasing with more than a three- to fourfold increase in velocity at the stenosis relative to the prestenotic segment. 

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