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ROENTGENOLOGIC DEMONSTRATION OF SPONTANEOUS REVERSAL OF PORTAL BLOOD FLOW IN CIRRHOSIS AND PRIMARY CARCINOMA OF THE LIVER

KUNIO OKUDA M.D.1, MIKIO MORIYAMA M.D.2, MASATAKE YASUMOTO M.D.2, SHIGENOBU JINNOUCHI M.D.2, YUTAKA SHIMOKAWA M.D.3, TOSHIMICHI NAKAYAMA M.D.4, YOSHIRO KANDA M.D.5, YOSHIO FUKYUAMA M.D.5, HIROTAKA MUSHA M.D5, SHINTARO KURATOMI M.D.6, and TOSHIRO NAKASHIMA M.D.7

1 Professor of Medicine, Chiba University School of Medicine, Chiba, Japan.
2 Second Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
3 Assistant Professor of Medicine, Kurume University School of Medicine.
4 Assistant Professor of Surgery, Kurume University School of Medicine.
5 First Department of Medicine, Chiba University School of Medicine.
6 First Department of Pathology, Kurume University School of Medicine.
7 Professor of Pathology, Kurume University School of Medicine.

Angiographic studies were carried out on 49 cases of liver cirrhosis and 47 cases of primary liver cell carcinoma.

An unequivocal retrograde portal blood flow was demonstrated in 1 cirrhotic patient. The portal vein was visualized during celiac arteriography in 5 patients with hepatoma, In 1, the portal flow was to- and-from, the direction depending upon the force of the contrast medium injection. In 4 hepatoma patients in whom retrograde portal flow was seen, there were tumor thrombi in the portal vein, and in 1 patient, in the collateral veins.

Thus, retrograde portal flow does occur in cirrhosis of the liver, but very rarely, and it occurs more often in primary liver cell carcinoma, probably due to arterial neovascularization and arteriovenous communications.


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